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161. Risk Factors for Abnormal Anteroposterior Knee Laxity After Primary Anterior Cruciate Ligament Reconstruction. (Abstract)

Risk Factors for Abnormal Anteroposterior Knee Laxity After Primary Anterior Cruciate Ligament Reconstruction. To identify preoperative and intraoperative factors associated with abnormal anterior knee laxity after primary anterior cruciate ligament (ACL) reconstruction.A total of 5,462 patients who underwent primary ACL reconstruction at our institution from January 2000 to October 2015, with no associated ligament injuries, were included. Demographic data, information regarding graft used (...) of having abnormal anterior knee laxity 6 months after primary ACL reconstruction.Level III, retrospective comparative trial.Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

2018 Arthroscopy

162. Editorial Commentary: Knee Anterior Cruciate Ligament Hamstring Graft Fixation Wars Continue: Does Analysis of a Small Fraction of the Story Resolve the Dilemma? Full Text available with Trip Pro

Editorial Commentary: Knee Anterior Cruciate Ligament Hamstring Graft Fixation Wars Continue: Does Analysis of a Small Fraction of the Story Resolve the Dilemma? After beginning with a search of more than 809 titles and ending up with 5 randomized controlled trials and 2 prospective comparative trials, the authors of a recent systematic review discovered that a statistically significant but nonclinical difference existed between anterior cruciate ligament reconstructions performed using

2018 Arthroscopy

163. Diagnostic Accuracy of Sequential Arthroscopic Approach for Ramp Lesions of the Posterior Horn of the Medial Meniscus in Anterior Cruciate Ligament-Deficient Knee. (Abstract)

Diagnostic Accuracy of Sequential Arthroscopic Approach for Ramp Lesions of the Posterior Horn of the Medial Meniscus in Anterior Cruciate Ligament-Deficient Knee. To document the diagnostic accuracy and steps for sequential arthroscopic exploration of ramp lesions-peripheral tear within 4 mm of meniscocapsular junction of medial meniscus-associated with anterior cruciate ligament (ACL) injury.This was a prospective consecutive study of 195 primary ACL reconstructions with arthroscopic (...) lesion without direct exploration through the posteromedial portal. Care should be taken to identify ramp lesions when ACL reconstruction is performed.Level I, diagnostic study of consecutive patients.Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

2018 Arthroscopy

164. Editorial Commentary: Buckle Up Surgeons: "Safety Belt" Reinforcement of Knee Anterior Cruciate Ligament Reconstruction Grafts. Full Text available with Trip Pro

Editorial Commentary: Buckle Up Surgeons: "Safety Belt" Reinforcement of Knee Anterior Cruciate Ligament Reconstruction Grafts. Safety belt, or cerclage, reinforcement of anterior cruciate ligament (ACL) grafts may protect against various modes of failure including creep and irreversible stretch, traumatic tearing, and slippage of the tendon-bone interface. A time-zero, biomechanical study shows that suture reinforcement may protect small and vulnerable hamstring ACL reconstruction grafts from

2018 Arthroscopy

165. Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees. Full Text available with Trip Pro

Complete tear of the lateral meniscus posterior root is associated with meniscal extrusion in anterior cruciate ligament deficient knees. This study aimed to evaluate the relationship between preoperative lateral meniscal extrusion (LME) and arthroscopic findings of lateral meniscus posterior root tear (LMPRT) in knees with anterior cruciate ligament (ACL) tear. Thirty-five knees that had LMPRTs with concomitant ACL tears on arthroscopy were evaluated. Patients were divided into two groups (...) , partial and complete root tears, via arthroscopic findings at the time of ACL reconstruction. For comparison, we added two groups, using the same database; 20 normal knees (normal group) and 20 ACL-injured knees without LM injury (intact LM group). We retrospectively measured preoperative LMEs using magnetic resonance imaging (MRI). Twenty-three knees had partial LMPRTs. Complete LMPRTs were observed in 12 knees. The average LME was -0.1 ± 0.4 mm in the normal group, 0.2 ± 0.5 mm in the intact LM

2018 Journal of Orthopaedic Research

166. Patients With Concomitant Intra-articular Lesions at Index Surgery Deteriorate in Their Knee Injury and Osteoarthritis Outcome Score in the Long Term More Than Patients With Isolated Anterior Cruciate Ligament Rupture: A Study From the Swedish National An (Abstract)

Patients With Concomitant Intra-articular Lesions at Index Surgery Deteriorate in Their Knee Injury and Osteoarthritis Outcome Score in the Long Term More Than Patients With Isolated Anterior Cruciate Ligament Rupture: A Study From the Swedish National An To analyze and compare clinical outcomes after anterior cruciate ligament (ACL) reconstruction 5 and 10 years postsurgery between patients with concomitant intra-articular injuries and those with isolated ACL injury (...) at reconstruction.Registrations were made using a web-based protocol by physicians for baseline and surgical data. Patients registered their Knee Injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at 5 and 10 years postsurgery. The exclusion criteria for the present study were revisions of previously unregistered ACL surgeries, non-ACL surgeries, patients for whom 10-year follow-up data had not yet been collected, and the proportion of index surgeries that were revision or contralateral interventions.There

2018 Arthroscopy

167. Distal femur morphology affects rotatory knee instability in patients with anterior cruciate ligament ruptures. (Abstract)

Distal femur morphology affects rotatory knee instability in patients with anterior cruciate ligament ruptures. Distal femur morphology has been shown to influence knee joint kinematics and may affect rotatory knee laxity. The purpose of this study was to determine the relationship between rotatory knee laxity and distal femoral morphology in patients with complete anterior cruciate ligament (ACL) rupture. It was hypothesized that increased posterior femoral condylar depth on standard lateral (...) radiographs, quantified as the "lateral femoral condyle ratio" would correlate with increased rotatory knee laxity, measured by a quantitative pivot shift test.Consecutive patients who underwent ACL reconstruction from 2014 to 2016 were retrospectively reviewed. A standardized pivot shift test was performed preoperatively on both knees and quantified using tablet technology. Using standard lateral radiographs of the knee, the ratio of posterior condylar distance over total condylar distance was defined

2018 Knee Surgery, Sports Traumatology, Arthroscopy

168. Supine lateral radiographs at 90° of knee flexion have a similar diagnostic accuracy for chronic posterior cruciate ligament injuries as stress radiographs. (Abstract)

Supine lateral radiographs at 90° of knee flexion have a similar diagnostic accuracy for chronic posterior cruciate ligament injuries as stress radiographs. This study aimed to evaluate whether supine lateral radiographs (SLRs) could replace stress radiographs for diagnosing chronic posterior cruciate ligament (PCL) injuries and identifying combined PCL injuries (defined as PCL injury with medial collateral ligament or posterolateral ligament complex injury).In this retrospective study, both (...) SLRs at 30° and 90° of knee flexion (30/90 SLRs) and Telos stress radiographs of patients with chronic PCL injuries (n = 38) and only 30/90 SLRs of healthy controls (n = 84) were taken. Injured-to-normal differences on 30/90 SLRs and stress radiographs were assessed. Correlation analysis was performed to evaluate injured-to-normal differences on 30/90 SLRs and stress radiographs in patients with chronic PCL injury. Subgroup analysis was performed to compare injured-to-normal differences on 30/90

2018 Knee Surgery, Sports Traumatology, Arthroscopy

169. Femoral Contact Forces in the Anterior Cruciate Ligament Deficient Knee: A Robotic Study. (Abstract)

that maintained the plug in its precise anatomic position. A robotic test system was used to flex the knee from 0° to 50° under 200-N tibiofemoral compression without and with a 2 Nm internal tibial torque, 5 Nm external tibial torque, and 45 N anterior tibial force (AF). CFs and knee kinematics were recorded before and after cutting the anterior cruciate ligament (ACL).ACL sectioning did not significantly increase medial or lateral CFs for any loading condition, with the exception of AF, in which increases (...) Femoral Contact Forces in the Anterior Cruciate Ligament Deficient Knee: A Robotic Study. To measure contact forces (CFs) at standardized locations representative of clinical articular cartilage defects on the medial and lateral femoral condyles during robotic tests with simulated weightbearing knee flexion.Eleven human knees had 20-mm-diameter cylinders of native bone/cartilage cored from both femoral condyles at standardized locations, with each cylinder attached to a custom-built load cell

2018 Arthroscopy

170. The Effect of Sacrificing the Posterior Cruciate Ligament in Total Knee Arthroplasties That Use a Highly Congruent Polyethylene Component. (Abstract)

The Effect of Sacrificing the Posterior Cruciate Ligament in Total Knee Arthroplasties That Use a Highly Congruent Polyethylene Component. There is continued debate regarding retention versus sacrificing of the posterior cruciate ligament (PCL) in total knee arthroplasty (TKA). We sought to determine if there was a difference in range of motion (ROM) after TKA between patients with PCL sacrifice versus PCL retention when using a highly congruent polyethylene insert.We conducted an Institutional (...) Review Board approved retrospective study of consecutive patients receiving TKA using the same implant with a highly congruent polyethylene component implanted by one surgeon from November 2013 to January 2016. Patients were placed in 2 groups based on whether the PCL was intact or released at the time of surgery. Patient charts were reviewed for age, body mass index, PCL status at surgery (incompetent, kept intact, or released), and preoperative/postoperative knee ROM.Both groups were similar

2018 Journal of Arthroplasty

171. Editorial Commentary: The Downstream Effects of Limited Hip Rotation and Femoroacetabular Impingement on the Anterior Cruciate Ligament: Could a Little Hip Stretching Every Day (or Surgery) Keep the Knee Doctor Away? Full Text available with Trip Pro

Editorial Commentary: The Downstream Effects of Limited Hip Rotation and Femoroacetabular Impingement on the Anterior Cruciate Ligament: Could a Little Hip Stretching Every Day (or Surgery) Keep the Knee Doctor Away? Patients with radiographic evidence of femoroacetabular impingement and decreased hip internal rotation have a higher rate of anterior cruciate ligament (ACL) tears. Limited internal rotation of the hip increases strain and potentially resultant fatigue failure of the ACL. Although (...) causation has not been proven, a better understanding of the lower extremity kinetic chain may allow improved ACL prevention strategies through measures (operative or nonoperative) to improve rotation of the hip.Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

2018 Arthroscopy

172. Editorial Commentary: More Evidence That Anterior Cruciate Ligament Deficiency Contributes to Knee Arthritis-In Search of an Optimal Biomechanical Model. Full Text available with Trip Pro

Editorial Commentary: More Evidence That Anterior Cruciate Ligament Deficiency Contributes to Knee Arthritis-In Search of an Optimal Biomechanical Model. Patients with anterior cruciate ligament (ACL) tears have a greater incidence of knee arthritis than the general population. Acute chondral injury, acute or delayed meniscal pathology, and altered contact mechanics have all been implicated in the development of arthritis. Dynamic models (i.e., testing during simulated knee motion) have shown (...) the biomechanical influence of ACL tears on knee laxity, although most investigations of contact mechanics rely on static models (i.e., testing during no relative tibiofemoral motion) wherein pressure distribution is mapped by thin films loaded in compression. A model that quantifies the change in contact mechanics during simulated knee motion after ACL tears, including stress distribution and shear stress, is desirable.Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All

2018 Arthroscopy

173. Extension of knee immobilization delays recovery of histological damages in the anterior cruciate ligament insertion and articular cartilage in rabbits Full Text available with Trip Pro

Extension of knee immobilization delays recovery of histological damages in the anterior cruciate ligament insertion and articular cartilage in rabbits [Purpose] To investigate the influence of knee immobilization period on recovery of histological damages in the anterior cruciate ligament (ACL) insertion and articular cartilage in rabbits. This knowledge is important for determining the appropriate rehabilitation approach for patients with ligament injuries, fracture, disuse atrophy (...) rate than the control group after 8 weeks of immobilization. After 8 weeks of remobilization, the ACL insertion and articular cartilage are not completely recovered after 4 and 8 weeks of immobilization, respectively. [Conclusion] Our results suggest that 8 weeks of remobilization will result in recovery of the ACL insertion after 2 weeks of knee immobilization, and recovery of the articular cartilage after 4 weeks of knee immobilization. If 8 weeks of immobilization occurs, a remobilization

2018 Journal of physical therapy science

174. Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations Full Text available with Trip Pro

Sex-Based Differences in Knee Kinetics With Anterior Cruciate Ligament Strain on Cadaveric Impact Simulations Females are at an increased risk of sustaining noncontact knee ligament injuries as compared with their male counterparts. The kinetics that load the anterior cruciate ligament (ACL) are still under dispute in the literature.The purpose of this study was to determine whether there are differences in knee kinetics between the sexes that lead to greater ACL strain in females when similar (...) to assess ligamentous loads during the simulated landing task. Uni- and multiaxial load cells and differential variable reluctance transducer strain sensors were utilized to collect kinetic data and maximum ACL strain for analysis. Conditions of external loads applied to the cadaveric limbs were systematically varied and randomized. Data were analyzed with 2-way repeated-measures analysis of variance and the Fisher exact test.Five kinetic parameters were evaluated. Of the 5 kinetic variables, only knee

2018 Orthopaedic journal of sports medicine

175. Modeling and classification of gait patterns between anterior cruciate ligament deficient and intact knees based on phase space reconstruction, Euclidean distance and neural networks Full Text available with Trip Pro

Modeling and classification of gait patterns between anterior cruciate ligament deficient and intact knees based on phase space reconstruction, Euclidean distance and neural networks The anterior cruciate ligament (ACL) plays an important role in stabilizing translation and rotation of the tibia relative to the femur. ACL injury alters knee kinematics and usually links to the alternation of gait patterns. The aim of this study is to develop a new method to distinguish between gait patterns (...) of patients with anterior cruciate ligament deficient (ACL-D) knees and healthy controls with ACL-intact (ACL-I) knees based on nonlinear features and neural networks. Therefore ACL injury will be automatically and objectively detected.First knee rotation and translation parameters are extracted and phase space reconstruction (PSR) is employed. The properties associated with the gait system dynamics are preserved in the reconstructed phase space. For the purpose of classification of ACL-D and ACL-I knee

2018 Biomedical engineering online

176. Knee Examination under Anesthesia: Development of a Predictive Score for Partial Anterior Cruciate Ligament Tears Full Text available with Trip Pro

Knee Examination under Anesthesia: Development of a Predictive Score for Partial Anterior Cruciate Ligament Tears To determine the accuracy of knee examination under anesthesia (EUA) and develop a prognostic score for partial anterior cruciate ligament (ACL) tears.A total of 229 patients with an ACL injury were included. Knee EUA was performed using the Lachman test, pivot shift test and arthrometric maximum manual side-to-side difference (AMMD) test. The arthroscopic examination is the gold (...) standard for the diagnosis of partial and complete ACL tears, which was compared with EUA findings. Multivariate logistic regression was estimated, and the significant variables were used to develop a predictive score.The relative risk for a complete tear with Lachman 2+ was 8.55 (range, 3.5 to 20.7) and 53.04 (range, 6.7 to 417) with Lachman 3+, compared to Lachman 1+. Negative pivot shift was reported in 23 cases in the partial tear group (76.7%) and in 22 in the complete tear group (11.1%). The AMMD

2018 Knee surgery & related research

177. Knee kinematics in anatomic anterior cruciate ligament reconstruction with four- and five-strand hamstring tendon autografts Full Text available with Trip Pro

Knee kinematics in anatomic anterior cruciate ligament reconstruction with four- and five-strand hamstring tendon autografts An alternative to the gold standard fourstrand hamstring tendon autograft for anterior cruciate ligament (ACL) reconstruction is the five-strand graft. The rationale for its use is to increase graft width to better restore the anatomical footprint and biomechanical properties of the native ACL when unable to create a four-strand graft of 8 mm in diameter. To date (...) , there are no trials assessing the use of this wider graft and its effect on the kinematics of the knee. The aim of this study was to determine whether the use of a wider five-strand hamstring tendon autograft in ACL reconstructive surgery better replicated the kinematics of a normal non-injured knee than the gold standard four-strand graft. Forty-four patients (27 operative and 17 normal control) were recruited for this study over a 12-month period. Twenty patients underwent anterior cruciate ligament

2018 Orthopedic reviews

178. A statistically compiled test battery for feasible evaluation of knee function after rupture of the Anterior Cruciate Ligament - derived from long-term follow-up data. Full Text available with Trip Pro

A statistically compiled test battery for feasible evaluation of knee function after rupture of the Anterior Cruciate Ligament - derived from long-term follow-up data. Clinical test batteries for evaluation of knee function after injury to the Anterior Cruciate Ligament (ACL) should be valid and feasible, while reliably capturing the outcome of rehabilitation. There is currently a lack of consensus as to which of the many available assessment tools for knee function that should be included (...) . The present aim was to use a statistical approach to investigate the contribution of frequently used tests to avoid redundancy, and filter them down to a proposed comprehensive and yet feasible test battery for long-term evaluation after ACL injury.In total 48 outcome variables related to knee function, all potentially relevant for a long-term follow-up, were included from a cross-sectional study where 70 ACL-injured (17-28 years post injury) individuals were compared to 33 controls. Cluster analysis

2017 PLoS ONE

179. Effectiveness of cross-education on knee strength and function after reconstruction of the anterior cruciate ligament. A systematic review

Effectiveness of cross-education on knee strength and function after reconstruction of the anterior cruciate ligament. A systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration

2020 PROSPERO

180. Both isolated and multi-ligament posterior cruciate ligament reconstruction results in improved subjective outcome: results from the Danish Knee Ligament Reconstruction Registry. (Abstract)

Both isolated and multi-ligament posterior cruciate ligament reconstruction results in improved subjective outcome: results from the Danish Knee Ligament Reconstruction Registry. There are few descriptions of outcomes after posterior cruciate ligament (PCL) reconstruction in the literature due to the rarity of this type of knee injury. Since 2005, the Danish Knee Ligament Reconstruction Registry (DKRR) has monitored outcomes of PCL reconstructions. This study describes the epidemiology of PCL (...) were compared with data on 21.820 primary anterior cruciate ligament (ACL) reconstructions.Isolated PCL reconstruction was performed in 43% of cases. Meniscus lesions and cartilage lesions were seen in 19 and 15% of cases, respectively. The main causes of PCL injuries were sports (43%) and traffic accidents (33%). The KOOS improved from pre-operative to 1-year follow-up for both isolated PCL reconstructions and multi-ligament PCL reconstructions but did not reach the levels of those recorded in ACL

2017 Knee Surgery, Sports Traumatology, Arthroscopy

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