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81. Longitudinal Changes in the Total Knee Joint Moment After Anterior Cruciate Ligament Reconstruction Correlate With Cartilage Thickness Changes. (Abstract)

Longitudinal Changes in the Total Knee Joint Moment After Anterior Cruciate Ligament Reconstruction Correlate With Cartilage Thickness Changes. This study investigated associations between changes in the total joint moment (TJM) at the knee and changes in cartilage thickness after anterior cruciate ligament reconstruction (ACLR). Seventeen subjects (five males; age: 29.6 ± 7.3 years) with unilateral ACLR underwent gait analysis and magnetic resonance imaging at baseline (2.2 ± 0.3 years post (...) in the central femoral subregion over the follow-up period, with similar trends in the external femoral subregion. The study results provide new insight into changes in the loading environment at the knee joint prospectively following ACL reconstruction and give evidence that there are modifiable gait metrics that are associated with cartilage changes after ACLR.© 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

2019 Journal of Orthopaedic Research

82. Editorial Commentary: The Measurement of Knee Laxity: Instrumented Measurement and Stress Radiography for Anterior Cruciate Ligament Injuries. Full Text available with Trip Pro

Editorial Commentary: The Measurement of Knee Laxity: Instrumented Measurement and Stress Radiography for Anterior Cruciate Ligament Injuries. The measurement of anterior knee laxity in anterior cruciate ligament injuries is an established method for both clinical practice and clinical studies in regard to anterior cruciate ligament surgery. Stress radiography was succeeded or paralleled by instrumented testing with the development of standardized devices starting in the 1980s. Because knee (...) stability depends on the flexion angle test, conditions need to be comparable for both instrumented testing and stress radiography. The lack of a general consensus becomes even more evident for testing and measuring rotational instability. Knee laxity measurement in all dimensions, such as with robots in cadaver studies, has not found its general application in the clinical setting yet, but will be expected in the near future.Copyright © 2019 Arthroscopy Association of North America. Published

2019 Arthroscopy

83. Effect of Blood Flow Restriction Training on Quadriceps Muscle Strength, Morphology, Physiology, and Knee Biomechanics Before and After Anterior Cruciate Ligament Reconstruction: Protocol for a Randomized Clinical Trial. (Abstract)

Effect of Blood Flow Restriction Training on Quadriceps Muscle Strength, Morphology, Physiology, and Knee Biomechanics Before and After Anterior Cruciate Ligament Reconstruction: Protocol for a Randomized Clinical Trial. Despite best practice, quadriceps strength deficits often persist for years after anterior cruciate ligament (ACL) reconstruction. Blood flow restriction training (BFRT) is a possible new intervention which applies a pressurized cuff to the proximal thigh that partially (...) occludes blood flow as the patient exercises, which enables patients to train at reduced loads. This training is believed to result in the same benefits as if the patients were training under high loads.The objective is to evaluate the effect of BFRT on quadriceps strength and knee biomechanics, and to identify the potential mechanism(s) of action of BFRT at the cellular and morphological levels of the quadriceps.This will be a randomized, double-blind, placebo-controlled clinical trial.The study

2019 Physical therapy Controlled trial quality: predicted high

84. Editorial Commentary: No Difference in Knee Osteoarthritis After Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction. Full Text available with Trip Pro

Editorial Commentary: No Difference in Knee Osteoarthritis After Single-Bundle Versus Double-Bundle Anterior Cruciate Ligament Reconstruction. Systematic reviews now play a key role in evidence-based medicine, summarizing empirical findings from evaluated studies on a specific problem and examining the variability of those. These reviews help scientists integrate and evaluate relevant information in their research and support practitioners in decision-making processes. Since the early years (...) of the current century, there has been a debate as to whether double-bundle or single-bundle reconstruction of the anterior cruciate ligament will better protect the knee. An essential aspect in the general indication of ligament reconstruction of the knee joint is the aim to prevent or at least to slow down the development process of osteoarthritis. At present, most clinical measures show no difference in outcome between single-bundle and double-bundle anterior cruciate ligament reconstruction. Systematic

2019 Arthroscopy

85. The use of allograft tissue in posterior cruciate, collateral and multi-ligament knee reconstruction. (Abstract)

The use of allograft tissue in posterior cruciate, collateral and multi-ligament knee reconstruction. Currently both autograft and allograft tissues are available for reconstruction of posterior cruciate, collateral and multi-ligament knee injuries. Decision-making is based on a complex interplay between anatomical structures, functional bundles and varying biomechanical requirements. Despite theoretically better biological healing and reduced risk of disease transmission autografts (...) are associated with donor site morbidity as well as being limited by size and quantity. The use of allografts eliminates donor-site morbidity but raises cost and issues of clinical effectiveness. The purpose of this paper is to review current concepts and evidence for the use of allografts in primary posterior cruciate, collateral and multi-ligament reconstructions.A narrative review of the relevant literature was conducted for PCL, collateral ligament and multi-ligament knee reconstruction. Studies were

2019 Knee Surgery, Sports Traumatology, Arthroscopy

86. MRI-determined anterolateral capsule injury did not affect the pivot-shift in anterior cruciate ligament-injured knees. (Abstract)

MRI-determined anterolateral capsule injury did not affect the pivot-shift in anterior cruciate ligament-injured knees. The purpose of this study was to quantitatively compare the results of pivot-shift test between knees with anterior cruciate ligament (ACL) injury with and without anterolateral capsule (ALC) injury detected on MRI. ALC injury was hypothesized to worsen rotatory knee laxity.82 patients with unilateral ACL injury were enrolled in this study. The pivot-shift test was performed (...) in the ALC+ (1.4 ± 1.2 m/s2) and ALC- (1.7 ± 1.3 m/s2) groups (n.s.). Examiner 2 found ALC injury in 28/82 knees (34%). Differences in clinical grading were not observed (glide/clunk/gross: ALC+ group 16/9/3 vs. ALC- group 26/25/3) (n.s.). However, the tibial acceleration in the ALC+ group (1.2 ± 0.8 m/s2) was significantly lower than that in the ALC- group (1.7 ± 1.3 m/s2, p = 0.03).Concomitant ALC injury in knees with ACL injury was not consistently detected on MRI and did not affect rotatory knee

2019 Knee Surgery, Sports Traumatology, Arthroscopy

87. Effects of Kinesio taping of the knee on proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture: A retrospective case series. Full Text available with Trip Pro

Effects of Kinesio taping of the knee on proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture: A retrospective case series. To investigate whether Kinesio tape (KT) application improves proprioception, balance, and functional performance in patients with anterior cruciate ligament rupture (ACLr).This retrospective analysis included 48 male patients with surgically-untreated ACLr who attended the Sports Medicine and Rehabilitation Center (...) in people with ACLr but cannot fully compensate for functional deficits. KT could be used to assist knee strengthening during rehabilitation.

2019 Medicine

88. Evaluation of Posterior Cruciate Ligament and Intercondylar Notch in Subjects With Anterior Cruciate Ligament Tear: A Comparative Flexed-Knee 3D Magnetic Resonance Imaging Study. (Abstract)

Evaluation of Posterior Cruciate Ligament and Intercondylar Notch in Subjects With Anterior Cruciate Ligament Tear: A Comparative Flexed-Knee 3D Magnetic Resonance Imaging Study. To determine if posterior cruciate ligament (PCL) and intercondylar notch (IN) morphometries and volumetrics act as risk factors for anterior cruciate ligament (ACL) tears.A prospective case-controlled magnetic resonance imaging (MRI) study was conducted with subjects presenting noncontact knee injuries. Exclusion (...) criteria were previous surgery, PCL tear, osteoarthritis, tumors, or infectious and inflammatory conditions. All participants underwent a flexed-knee 3-dimensional (3D) magnetic resonance imaging (MRI) to uniformly straighten PCL. MR images were independently reviewed by 2 radiologists and assessed for 2D and 3D measurements (bicondylar width; IN angle, depth, width, and cross-sectional area; PCL width, thickness, and cross-sectional area; and IN and PCL volumes). Clinical profiles were tabulated

2017 Arthroscopy

89. Anterior cruciate ligament graft fixation first in anterior and posterior cruciate ligament reconstruction best restores knee kinematics. (Abstract)

Anterior cruciate ligament graft fixation first in anterior and posterior cruciate ligament reconstruction best restores knee kinematics. To evaluate the effect of different graft fixation sequences in one-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction on (1) knee biomechanics and (2) tibiofemoral alignment.Twelve porcine knees were used in this study. Five fixation sequences were performed (angle indicating knee flexion): (a) PCL at 30° and ACL (...) at 30°, (b) PCL at 90° and ACL at 30°, (c) ACL at 30° and PCL at 30°, (d) ACL at 30° and PCL at 90°, and (e) ACL and PCL simultaneous fixation at 30°. Anterior and posterior tibial translation was measured under an 89 N load. A 3-D digitizer was used to measure the change in anteroposterior (AP) tibiofemoral position.None of the graft fixation sequences restored the AP laxity of the intact knee, and there are minimal differences in the in situ tissue forces in the ACL and PCL grafts

2017 Knee Surgery, Sports Traumatology, Arthroscopy

90. Patients undergoing total knee arthroplasty using a contemporary patella-friendly implant are unaware of any differences due to patellar resurfacing. (Abstract)

Patients undergoing total knee arthroplasty using a contemporary patella-friendly implant are unaware of any differences due to patellar resurfacing. Anterior knee pain after total knee arthroplasty (TKA) is often unexplained, spurring ongoing debates on the need for patellar resurfacing. It was hypothesized that a contemporary patella-friendly implant would restore patellofemoral kinematics more physiologically than outdated implants and that there would be no perceived or clinically (...) based on patient-reported outcomes [anterior knee pain, Forgotten Joint Score (FJS), and side preference], physician-rated results [Feller patellofemoral (PF) score], radiographic patellar position, patella-related complications, and need for reoperation.There were no differences in midterm rates of anterior knee pain (RP 8%; non-RP 4%; n.s.), FJS (all n.s.), or side preference (RP 47%; non-RP 45%; n.s.), nor did the groups differ by Feller PF score (all n.s.) or radiographic patellar position (all

2018 Knee Surgery, Sports Traumatology, Arthroscopy Controlled trial quality: uncertain

91. Evaluation of the Effect of the Sulcus Angle and Lateral to Medial Facet Ratio of the Patellar Groove on Patella Tracking in Aging Subjects with Stable Knee Joint Full Text available with Trip Pro

Evaluation of the Effect of the Sulcus Angle and Lateral to Medial Facet Ratio of the Patellar Groove on Patella Tracking in Aging Subjects with Stable Knee Joint To determine whether the sulcus angle and the lateral to medial facet ratio correlate with patella lateral displacement and tilt in patients without patella instability.Computed tomography images of the lower limb of 64 patients without known arthropathy were collected. Three-dimensional models of the lower limb with a unified (...) = 0.8406) and positively correlated with the bisect offset index (p = 0.003, r = 0.634) and patellar tilt (p = 0.03, r = 0.551); the lateral to medial facet ratio was positively correlated with TT-TG distance (p = 0.003, r = 0.643) and bisect offset index (p = 0.026, r = 0.559).The sulcus angle and lateral to medial facet ratio of the patellar groove can influence patella tracking in patients with stable knee joints.

2018 BioMed research international

92. WITHDRAWN: Interventions for treating posterior cruciate ligament injuries of the knee in adults. (Abstract)

WITHDRAWN: Interventions for treating posterior cruciate ligament injuries of the knee in adults. Injuries of the posterior cruciate ligament (PCL) of the knee frequently occur in automobile accidents and sports injuries, although they are less frequent overall than injuries of the anterior cruciate ligament (ACL). Some patients show significant symptoms and subsequent articular deterioration, while others are essentially asymptomatic, maintaining habitual function. Management of PCL injuries (...) were evaluated independently by two review authors.No randomized or quasi-randomized controlled studies meeting the selection criteria were identified.Future research should include randomized controlled trials of acute isolated PCL injuries, or PCL injuries when combined with other ligament injuries of the knee, treated operatively and conservatively. Adequate numbers of patients and an objective methodology for patient evaluation must be used in future studies of these interventions to determine

2012 Cochrane

93. Treatment of recurrent patellar dislocation via knee arthroscopy combined with C-arm fluoroscopy and reconstruction of the medial patellofemoral ligament Full Text available with Trip Pro

Treatment of recurrent patellar dislocation via knee arthroscopy combined with C-arm fluoroscopy and reconstruction of the medial patellofemoral ligament Recurrent patellar dislocations were treated via knee arthroscopy combined with C-arm fluoroscopy, and reconstruction of the medial patellofemoral ligaments. Between October 2013 and March 2017, 52 cases of recurrent patellar dislocation [27 males and 25 females; age, 16-47 years (mean, 21.90 years)] were treated. Arthroscopic exploration (...) term, recurrent patellar dislocation treatment via knee arthroscopy combined with C-arm fluoroscopy and reconstruction of the medial patellofemoral ligament was effective.

2018 Experimental and therapeutic medicine

94. Editorial Commentary: Medial Patellofemoral Ligament Reconstruction for Knee Patellar Instability: When Are Soft Tissue Procedures Not Enough? Full Text available with Trip Pro

Editorial Commentary: Medial Patellofemoral Ligament Reconstruction for Knee Patellar Instability: When Are Soft Tissue Procedures Not Enough? Medial patellofemoral ligament reconstruction is commonly performed to treat patellofemoral instability by recreating the static soft tissue restraint to lateral patellar translation. Concurrent tibial tuberosity osteotomy can be indicated in the setting of bony malalignment, such as a lateralized tuberosity or patella alta; however, the exact (...) indications for this have been difficult to define due to the multifactorial nature of this problem. Understanding the role of tuberosity lateralization and patella alta on the function of medial patellofemoral ligament grafts can help to identify the interplay of some factors that contribute to patellar stability and improve our understanding of when and how concurrent tibial tuberosity osteotomy may be indicated.Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All

2018 Arthroscopy

95. A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone ? patellar tendon ? bone autograft, hamstring autograft, and allograft

A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone ? patellar tendon ? bone autograft, hamstring autograft, and allograft A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone – patellar tendon – bone autograft, hamstring autograft, and allograft A cost-effectiveness analysis comparing 3 anterior cruciate ligament graft types: bone – patellar tendon – bone autograft, hamstring autograft, and allograft Genuario JW, Faucett SC (...) that quadrupled hamstring tendon autograft appeared to be the most cost-effective method. There were a few limitations to the study methods and reporting, so the authors’ conclusions should be considered with caution. Type of economic evaluation Cost-effectiveness analysis, cost-utility analysis Study objective The objective was to evaluate the cost-effectiveness of the three most common types of graft, for anterior cruciate ligament reconstruction. Interventions The interventions were bone to patellar tendon

2012 NHS Economic Evaluation Database.

96. Exercise-Based Knee and Anterior Cruciate Ligament Injury Prevention Full Text available with Trip Pro

pathology including damage to the joint (patellofemoral and/or tibiofemoral), ligaments, meniscus, or patellar tendon. Articles that focused on preventing knee injuries as a whole were included, but so too were articles focused on only one type of knee injury (eg, anterior cruciate ligament [ACL] injuries or patellofemoral pain). This CPG delineates between evidence related to ACL injuries and all knee injuries. Mechanism of injury included both contact (injuries as a result of collision with another (...) Prevention Programs Clinicians should recommend use of exercise-based knee injury prevention programs in athletes for the prevention of knee and anterior cruciate ligament (ACL) injuries. Programs for reducing all knee injuries include 11+ and FIFA 11, HarmoKnee, and Knäkontroll; and those used by Emery and Meeuwisse, Goodall et al, Junge et al, LaBella et al, Malliou et al, Olsen et al, Pasanen et al, Petersen et al, and Wedderkopp et al. Programs for reducing ACL injuries include HarmoKnee, Knäkontroll

2018 The Orthopaedic Section of the American Physical Therapy Association (APTA), Inc.

97. Cryotherapy Machines versus Ice Packs for the Post-Operative Management of Anterior Cruciate Ligament Replacement Surgery or Total Knee Arthroplasty: Clinical Evidence and Guidelines

. These are followed by randomized controlled trials, non-randomized studies, and evidence-based guidelines. Two randomized controlled trials regarding the use of cryotherapy machines for the post- operative management of anterior cruciate ligament (ACL) replacement surgery or total knee arthroplasty (TKA). No relevant health technology assessment reports, systematic reviews, meta-analyses, non-randomized studies, or evidence-based guidelines were identified. Additional references of potential interest, including (...) Cryotherapy Machines versus Ice Packs for the Post-Operative Management of Anterior Cruciate Ligament Replacement Surgery or Total Knee Arthroplasty: Clinical Evidence and Guidelines Disclaimer: The Rapid Response Service is an information service for those involved in planning and providing health care in Canada. Rapid responses are based on a limited literature search and are not comprehensive, systematic reviews. The intent is to provide a list of sources of the best evidence on the topic

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

98. Knee stability and movement coordination impairments: knee ligament sprain revision 2017.

the physical impairments, activity limitations, and participation restrictions associated with knee ligament sprain. Clinicians may use the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) instrument as a validated patient-reported outcome measure to assess psychological factors that may hinder return to sports before and after interventions intended to alleviate fear of reinjury associated with knee ligament sprain. ( Grade of Recommendation: B ) Physical Performance Measures Clinicians (...) to decrease postoperative pain after anterior cruciate ligament (ACL) reconstruction. ( Grade of Recommendation: C ) Early Weight Bearing Clinicians may implement early weight bearing as tolerated (within 1 week after surgery) for patients after ACL reconstruction. ( Grade of Recommendation: C ) Knee Bracing Clinicians may use functional knee bracing in patients with ACL deficiency. ( Grade of Recommendation: C ) Clinicians should elicit and document patient preferences in the decision to use functional

2017 National Guideline Clearinghouse (partial archive)

99. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain Full Text available with Trip Pro

Activity Rating Scale to assess activity level, before and after interventions intended to alleviate the physical impairments, activity limitations, and participation restrictions associated with knee ligament sprain. Clinicians may use the Anterior Cruciate Ligament-Return to Sport after Injury (ACL-RSI) instrument as a validated patient-reported outcome measure to assess psychological factors that may hinder return to sports before and after interventions intended to alleviate fear of reinjury (...) in the immediate postoperative period to decrease postoperative pain after anterior cruciate ligament (ACL) reconstruction. Interventions – Early Weight Bearing Clinicians may implement early weight bearing as tolerated (within 1 week after surgery) for patients after ACL Reconstruction. Interventions – Knee Bracing Clinicians may use functional knee bracing in patients with ACL deficiency. Clinicians should elicit and document patient preferences in the decision to use functional knee bracing following ACL

2017 American Physical Therapy Association

100. Anterior Cruciate Ligament Injury—Who Succeeds Without Reconstructive Surgery? The Delaware-Oslo ACL Cohort Study Full Text available with Trip Pro

Anterior Cruciate Ligament Injury—Who Succeeds Without Reconstructive Surgery? The Delaware-Oslo ACL Cohort Study More than 50% of highly active patients with an anterior cruciate ligament (ACL) injury who choose nonsurgical treatment (active rehabilitation alone) have successful 2-year outcomes and comparable knee function to an uninjured population. Early predictive factors for a successful outcome may aid treatment decision making in this population.To identify early predictors (...) injuries. A successful 2-year outcome was defined as having 2-year International Knee Documentation Committee (IKDC) scores ≥15th normative percentile and not undergoing ACL reconstruction. Multivariable logistic regression models were built using demographic and knee function data (quadriceps muscle strength, 4 single-leg hop tests, IKDC score, and Knee Outcome Survey-Activities of Daily Living Scale [KOS-ADLS] score) collected at baseline or after a 5-week neuromuscular and strength training (NMST

2018 Orthopaedic journal of sports medicine

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