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141. The presence of concomitant intra-articular injuries and bone bruise does not affect pre-operative knee pain and symptoms in patients undergoing anterior cruciate ligament reconstruction. (Abstract)

The presence of concomitant intra-articular injuries and bone bruise does not affect pre-operative knee pain and symptoms in patients undergoing anterior cruciate ligament reconstruction. Increased knee pain at the time of anterior cruciate ligament (ACL) reconstruction may predict increased pain post-operatively, a prolonged recovery and a more difficult rehabilitation. The main objective of our study was to identify preoperative factors, such as concomitant intra-articular injuries and bone (...) bruises, that may be associated with increased knee pain and symptoms in patients undergoing ACL reconstruction.Patient data was queried from our institution's prospectively maintained ACL reconstruction registry. Two-hundred and seventy patients who underwent primary ACL reconstruction within 3 months of injury were included in the study. Predictors such as demographic characteristics (age, body mass index and gender) and injury characteristics (mechanism of injury, meniscal injury, chondral injury

2018 Knee Surgery, Sports Traumatology, Arthroscopy

142. Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position. Full Text available with Trip Pro

Meniscal repair concurrent with anterior cruciate ligament reconstruction restores posterior shift of the medial meniscus in the knee-flexed position. The purpose of this study was to evaluate the shape and shift of the medial meniscus before and after meniscal repair concurrent with anterior cruciate ligament (ACL) reconstruction using magnetic resonance imaging (MRI) at 90° of knee flexion.This study included 18 patients with ACL-deficient knees without meniscus tears (group A), 11 patients (...) with medial meniscus tears alone (group M), and 15 patients with ACL-deficient knees complicated with medial meniscus tears (group AM). The posterior segment shape was evaluated using open MRI at 90° of knee flexion preoperatively and at 3 months postoperatively. The length, height, width, and posterior extrusion of the medial meniscus and posterior tibiofemoral distance were measured. These measurements were compared between the three groups.On preoperative MRI, a significant difference was observed

2018 Knee Surgery, Sports Traumatology, Arthroscopy

143. High Muscle Co-Contraction Does Not Result in High Joint Forces During Gait in Anterior Cruciate Ligament Deficient Knees. Full Text available with Trip Pro

High Muscle Co-Contraction Does Not Result in High Joint Forces During Gait in Anterior Cruciate Ligament Deficient Knees. The mechanism of knee osteoarthritis development after anterior cruciate ligament injuries is poorly understood. The objective of this study was to evaluate knee gait variables, muscle co-contraction indices and knee joint loading in young subjects with anterior cruciate ligament deficiency (ACLD, n = 36), versus control subjects (n = 12). A validated, electromyography (...) limb (mean difference = 0.57 body weight, p = 0.007, effect size = 1.14). Similar observations were made for total contact force. For involved versus uninvolved limb, the ACLD group demonstrated lower vertical ground reaction force (mean difference = 0.08 body weight, p = 0.010, effect size = 0.70) and knee flexion moment (mean difference = 1.32% body weight * height, p = 0.003, effect size = 0.76), during weight acceptance. These results indicate that high muscle co-contraction does not always

2018 Journal of Orthopaedic Research

144. Clinical and radiologic evaluation of the posterior cruciate ligament-injured knee Full Text available with Trip Pro

Clinical and radiologic evaluation of the posterior cruciate ligament-injured knee Accurate isolated PCL diagnosis continues to present a challenge. This article reviews the current literature regarding clinical and radiographic evaluation of PCL injuries.A thorough history to understand the mechanism of injury should begin any evaluation. Several clinical tests have been shown to effectively assess PCL laxity, with the posterior drawer test possessing the highest sensitivity and specificity (...) . Any thorough exam should compare the contralateral, uninjured leg. If a PCL or multi-ligament injury is suspected, plain radiographs should be performed to avoid missing a fracture or avulsion. An MRI represents the current gold standard for diagnosing ligament injuries in the knee and should always be obtained in these cases. Due to the significant incidence of nerve injuries (25%) and vascular injuries (18%) with knee dislocations, any suspicion of neurovascular compromise necessitates further

2018 Current reviews in musculoskeletal medicine

145. Two-Plane Assessment of Knee Muscles Isometric and Isokinetic Torques After Anterior Cruciate Ligament Reconstruction Full Text available with Trip Pro

Two-Plane Assessment of Knee Muscles Isometric and Isokinetic Torques After Anterior Cruciate Ligament Reconstruction BACKGROUND We tested the hypothesis that, in patients participating in 17 weeks of postoperative physiotherapy after anterior cruciate ligament reconstruction (ACLR), maximal isometric torque (IT) and peak torque (PT) generated by the muscles affecting the operated knee joint in the sagittal and transverse planes are not restored. We also present the application of IT and PT (...) measurements of the muscles affecting the knee joint in 2 planes of motion. MATERIAL AND METHODS IT and PT of the knee extensor and flexor muscles and the muscles internally rotating the shin were measured in 30 males who participated in postoperative physiotherapy for 17 weeks after ACLR (ACLR group) and 30 males with no injuries (control group). RESULTS Significantly lower IT and PT values were noted in the operated knee extensors and flexors. The differences were also noted in the PT for the muscles

2018 Medical science monitor : international medical journal of experimental and clinical research

146. Ankle perturbation generates bilateral alteration of knee muscle onset times after unilateral anterior cruciate ligament reconstruction Full Text available with Trip Pro

Ankle perturbation generates bilateral alteration of knee muscle onset times after unilateral anterior cruciate ligament reconstruction The aim of this study was to compare muscle activation onset times of knee muscles between the involved and uninvolved knee of patients with unilateral anterior cruciate ligament reconstruction (ACLR), and the uninjured knees of healthy subjects after a controlled perturbation at the ankle level.Fifty male amateur soccer players, 25 with unilateral ACLR using (...) ) analysis to assess the neuromuscular function of knee muscles.Subjects with ACLR had significant delays in EMG onset in the involved (VM = 99.9 ± 30 ms; ST = 101.7 ± 28 ms) and uninvolved knee (VM = 100.4 ± 26 ms; ST = 104.7 ± 28 ms) when compared with the healthy subjects (VM = 69.1 ± 9 ms; ST = 74.6 ± 9 ms). However, no difference was found between involved and uninvolved knee of the ACLR group.The results show a bilateral alteration of knee muscles in EMG onset after a unilateral ACLR, responses

2018 PeerJ

147. Is poor proprioception associated with worse movement quality of the knee in individuals with anterior cruciate ligament deficiency or reconstruction? Full Text available with Trip Pro

Is poor proprioception associated with worse movement quality of the knee in individuals with anterior cruciate ligament deficiency or reconstruction? [Purpose] To investigate the association between proprioception and a knee medial to foot position during weight-bearing activities in patients with anterior cruciate ligament reconstruction and anterior cruciate ligament deficiency. [Participants and Methods] Thirty-eight patients with anterior cruciate ligament reconstruction and 13 patients (...) with anterior cruciate ligament deficiency aged 18-40 years were included. Proprioception was assessed by knee kinesthesia measured by the threshold to detection of passive motion. Movement quality was assessed by visual observation of the position of the knee in relation to the foot during the mini squat, the single-leg hop for distance, and the cross-over hop for distance. [Results] In patients with anterior cruciate ligament deficiency, worse kinesthesia was significantly associated with a knee medial

2018 Journal of physical therapy science

148. Inertial Sensor Angular Velocities Reflect Dynamic Knee Loading during Single Limb Loading in Individuals Following Anterior Cruciate Ligament Reconstruction Full Text available with Trip Pro

Inertial Sensor Angular Velocities Reflect Dynamic Knee Loading during Single Limb Loading in Individuals Following Anterior Cruciate Ligament Reconstruction Difficulty quantifying knee loading deficits clinically in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. Expense associated with quantifying knee moments (KMom) and power (KPow) with gold standard techniques precludes their use in the clinic. As segment and joint kinematics are used (...) to calculate moments and power, it is possible that more accessible inertial sensor technology can be used to identify knee loading deficits. However, it is unknown if angular velocities measured with inertial sensors provide meaningful information regarding KMom/KPow during dynamic tasks post-ACLr. Twenty-one individuals 5.1 ± 1.5 months post-ACLr performed a single limb loading task, bilaterally. Data collected concurrently using a marker-based motion system and gyroscopes positioned lateral thighs

2018 Sensors (Basel, Switzerland)

149. Surgical Technique for Release of Anterior Interval Scarring of the Knee After Anterior Cruciate Ligament Reconstruction Full Text available with Trip Pro

Surgical Technique for Release of Anterior Interval Scarring of the Knee After Anterior Cruciate Ligament Reconstruction Postoperative scarring is a known complication after arthroscopic anterior ligament reconstruction of the knee. The anterior interval of the knee has been previously identified as a common location for anterior scar formation. The anterior interval is defined as the space between the infrapatellar fat pad and the anterior border of the tibia. Patients with anterior interval (...) scarring often present with lack of terminal knee extension, anterior knee pain, decreased patellar mobility, and quadriceps atrophy. The goal of this paper is to describe the technique for anterior interval release of the knee.

2018 Arthroscopy techniques

150. Tibial Part of Anterior Cruciate Ligament: A Host for Silent Foreign Body in the Knee Full Text available with Trip Pro

Tibial Part of Anterior Cruciate Ligament: A Host for Silent Foreign Body in the Knee 30058592 2018 12 11 2018 12 11 2542-5641 131 15 2018 Aug 05 Chinese medical journal Chin. Med. J. Tibial Part of Anterior Cruciate Ligament: A Host for Silent Foreign Body in the Knee. 1884-1886 10.4103/0366-6999.237410 Tutkus Vytautas V Centre of Plastic and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius LT-08661; Department of Anatomy, Histology and Anthropology, Faculty of Medicine (...) -03101, Lithuania. Silove Simona S Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania. Tutkuviene Janina J Department of Anatomy, Histology and Anthropology, Faculty of Medicine, Vilnius University, Vilnius LT-03101, Lithuania. eng Letter China Chin Med J (Engl) 7513795 0366-6999 IM Anterior Cruciate Ligament pathology Anterior Cruciate Ligament Injuries Biomechanical Phenomena Foreign Bodies Humans Knee Joint pathology Tibia

2018 Chinese medical journal

151. How to Rapidly Abolish Knee Extension Deficit After Injury or Surgery: A Practice-Changing Video Pearl From the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group Full Text available with Trip Pro

How to Rapidly Abolish Knee Extension Deficit After Injury or Surgery: A Practice-Changing Video Pearl From the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group Knee extension deficit is frequently observed after anterior cruciate ligament reconstruction or rupture and other acute knee injuries. Loss of terminal extension often occurs because of hamstring contracture and quadriceps inactivation rather than mechanical intra-articular pathology. Failure to regain (...) full extension in the first few weeks after anterior cruciate ligament reconstruction is a recognized risk factor for adverse long-term outcomes, and therefore, it is important to try to address it. In this Technical Note, a simple, rapid, and effective technique to help regain full knee extension and abolish quadriceps activation failure is described.

2018 Arthroscopy techniques

152. Suture Augmentation: An Alternative to Reconstruction for Incomplete Posterior Cruciate Ligament Injuries in the Multiple Ligament–Injured Knee Full Text available with Trip Pro

Suture Augmentation: An Alternative to Reconstruction for Incomplete Posterior Cruciate Ligament Injuries in the Multiple Ligament–Injured Knee Treatment of posterior cruciate ligament injuries remains controversial, particularly in the case of partial or incomplete tears in the context of a multiple ligament-injured knee. Suture augmentation, or internal bracing, has been shown in other ligament and tendon repairs or reconstructions to provide stable biomechanics and facilitate early return (...) to activity. In the knee, suture augmentation has previously been used for the treatment of medial collateral ligament tears and in the support of anterior cruciate ligament reconstructions. We describe our arthroscopic technique for suture augmentation of incomplete posterior cruciate ligament injuries.

2018 Arthroscopy techniques

153. Effects of posterior condylar osteophytes on gap balancing in computer-assisted total knee arthroplasty with posterior cruciate ligament sacrifice Full Text available with Trip Pro

Effects of posterior condylar osteophytes on gap balancing in computer-assisted total knee arthroplasty with posterior cruciate ligament sacrifice Gap planning in navigated total knee arthroplasty (TKA) is a critical concern. Osteophytes are normally removed prior to gap planning, with the exception of posterior condylar osteophytes of the femur, which are removed after posterior condylar resection. This study investigated how posterior condylar osteophytes affect gap balancing during (...) surgery.This prospective study was conducted on 40 primary varus osteoarthritic knees with a posterior condylar osteophyte that underwent TKA navigation. For all knees, computed tomography (CT) was performed to evaluate osteophyte position. The extension gap and flexion gap were determined under navigation using a tension device with a distraction force of 44 lb. The extension gap and flexion gap were measured before and after osteophyte removal.This study revealed that the average osteophyte thickness

2018 European Journal of Orthopaedic Surgery & Traumatology

154. Proprioceptive Changes in Bilateral Knee Joints Following Unilateral Anterior Cruciate Ligament Injury in Cynomolgus Monkeys Full Text available with Trip Pro

Proprioceptive Changes in Bilateral Knee Joints Following Unilateral Anterior Cruciate Ligament Injury in Cynomolgus Monkeys BACKGROUND The anterior cruciate ligament (ACL) is one of the most important structures maintaining stability of knee joints, and the proprioception of the ACL plays a key role in it. If the ACL is injured in the unilateral knee joint, it changes nerve electrophysiology, morphology, and quantity of the proprioceptors in the bilateral ACL. The aim of this study (...) was to explore the proprioceptive changes in the bilateral knee joints following unilateral ACL injury, and to provide a theoretical foundation and ideas for clinical treatment. MATERIAL AND METHODS Nine normal cynomolgus monkeys were chosen and used to developed a model of unilateral ACL injury, and 3 monkeys without modeling were used as blank control. At the 4th, 8th, and 12th weeks, the changes in ACL nerves were inspected using electrophysiology [somatosensory evoked potentials (SEPs) and motor nerve

2018 Medical science monitor : international medical journal of experimental and clinical research

155. COMPARISON OF THE ‘BACK IN ACTION’ TEST BATTERY TO STANDARD HOP TESTS AND ISOKINETIC KNEE DYNAMOMETRY IN PATIENTS FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION Full Text available with Trip Pro

COMPARISON OF THE ‘BACK IN ACTION’ TEST BATTERY TO STANDARD HOP TESTS AND ISOKINETIC KNEE DYNAMOMETRY IN PATIENTS FOLLOWING ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION Limb symmetry after anterior cruciate ligament reconstruction may be evaluated using maximal strength and hop tests, which are typically reported using Limb Symmetry Indices (LSIs) which may overestimate function.The purpose of this study was to compare the Back in Action (BIA) test battery to standard hop and muscle strength (...) tests used to determine readiness to return to sport (RTS).Prospective cohort.Over two test sessions, 40 ACLR patients were assessed at a mean 11.3 months post-surgery. Initially, participants completed the 6 m timed hop and the single, triple and triple crossover hops for distance, and isokinetic knee extensor and flexor strength assessment. The second session involved completion of the BIA battery, including stability tests, single and double leg countermovement jumps (CMJ), and plyometric, speedy

2018 International journal of sports physical therapy

156. Editorial Commentary: Revision Knee Anterior Cruciate Ligament Reconstruction: Failure Rates Appear to Have Declined yet Different Research Methods Could Show Different Results. Full Text available with Trip Pro

Editorial Commentary: Revision Knee Anterior Cruciate Ligament Reconstruction: Failure Rates Appear to Have Declined yet Different Research Methods Could Show Different Results. In the past decade there has been a rapid expansion in the available evidence for outcomes after revision knee anterior cruciate ligament reconstructions including data from 2 large registries and a growing body of research. The advent of 2 large registries and a growing body of evidence have provided a refined view

2018 Arthroscopy

157. Total Knee Arthroplasty in Patients With Prior Anterior Cruciate Ligament Reconstruction. (Abstract)

Total Knee Arthroplasty in Patients With Prior Anterior Cruciate Ligament Reconstruction. Few studies have analyzed the outcomes of total knee arthroplasty (TKA) in patients with prior anterior cruciate ligament (ACL) reconstruction, and the reported outcomes are controversial. The purpose of this study is to assess if prior ACL reconstruction had any impact on the outcome of subsequent TKA.A matched case-control study was conducted in patients who underwent TKA, including 37 with prior ACL (...) in surgery. The main difficulty in most ACL patients was due to varus deformity and increased retraction of the medial soft structures which required progressive medial release. Other 2 knees had difficult knee exposure. One was an unexpected partial patellar tendon avulsion and the other required planned quadriceps snip.TKA was an effective procedure for patients with prior ACL reconstruction. The surgeon should be warned of the possible difficulties in the knee exposure and possible need of medial

2018 Journal of Arthroplasty

158. Editorial Commentary: Looking Outside the Box With Ultrasound in an Anterior Cruciate Ligament-Deficient Knee: Welcome to Surgery 2.0. Full Text available with Trip Pro

Editorial Commentary: Looking Outside the Box With Ultrasound in an Anterior Cruciate Ligament-Deficient Knee: Welcome to Surgery 2.0. Perspectives on the anterolateral ligament have changed greatly since the first articles were published that cast doubt on the existence of this structure. The current debate is centered on how to best analyze it. Surgeons are increasingly focusing on the knee's secondary restraints. It is important to understand that magnetic resonance imaging is not the only

2018 Arthroscopy

159. Editorial Commentary: The Quest to Prevent Knee Anterior Cruciate Ligament Bone Tunnel Widening Continues. Full Text available with Trip Pro

Editorial Commentary: The Quest to Prevent Knee Anterior Cruciate Ligament Bone Tunnel Widening Continues. The exploration of methods to improve healing of a tendon graft in a bone tunnel in anterior cruciate ligament reconstruction has been a subject of basic and translational research for over 30 years. It is well recognized that the graft attachment site to the bone represents the "weak link" in the early healing period. We as clinicians search for methods to augment healing of the tendon

2018 Arthroscopy

160. Prior Anterior Cruciate Ligament Reconstruction Effects on Future Total Knee Arthroplasty. (Abstract)

Prior Anterior Cruciate Ligament Reconstruction Effects on Future Total Knee Arthroplasty. The impact of prior anterior cruciate ligament (ACL) reconstruction on total knee arthroplasty (TKA) has rarely been studied. The objective of this study was to compare intraoperative characteristics in patients who underwent TKA with pre-existing hardware from prior ACL reconstruction with a matched cohort control group.A retrospective study of patients who had undergone primary TKA with pre-existing (...) hardware from prior ACL reconstruction was performed from June 2012 through June 2017. These patients were 2-to-1 matched to the ACL group based on similar patient demographic and provider variables. Outcomes investigated included operative time, estimated blood loss (EBL), and postoperative complications.One hundred one patients met the inclusion/exclusion criteria. The mean age was 54 ± 9 years, and the mean body mass index was 32.6 ± 6.5 kg/m2. The ACL group was divided into 4 subgroups: group 1

2018 Journal of Arthroplasty

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