Recent research progress from biological perspective on the mechanism of formation of osteoarthritis after anterior cruciate ligament injury

The anterior cruciate ligament(ACL)mainly plays a role in stabilizing the knee joint by limiting the forward translation of tibial force and rotational force at the tibial joint,and if this ligament is damaged,it will cause joint pain,limited mobility,knee instability,etc.According to related studies,the incidence of traumatic osteoarthritis(PTOA)after ACL injury is as high as 87%,although many studies have shown that patients with ACL injury are susceptible to PTOA,but the exact mechanism is currently unknown.This may be related to biological,structural,and mechanical factors caused by the ligament injury.Previous studies have shown that elevated inflammatory mediators in the joint cavity following ACL injury can lead to chondrocytes necrosis and degradation of the cartilage matrix.These potential biochemical mediators contribute to PTOA formation,and early intervention can reduce future episodes of PTOA.In recent years,many scholars have devoted themselves to studying the potential important factors and signaling pathways involved in the formation of osteoarthritis after ACL injury,and exploring its molecular mechanism,which has led to great progress in this field.This paper mainly studies and discusses the mechanism of osteoarthritis formation after ACL injury from the biological perspective.

Analysis of the Application of Sports Medicine Ultrasound in the Rehabilitation of Anterior Talofibular Ligament Injury

Objective: To explore the application effect of sports medicine ultrasound in the rehabilitation treatment of anterior talofibular ligament injury. Methods: 36 patients who visited our hospital from January 2020 to September 2023 were selected as research subjects and randomly divided into the study group (18 cases) and the control group (18 cases). The control group adopted routine examination and rehabilitation training, and the study group adopted sports medicine ultrasound and rehabilitation training. The ankle function scores and daily living ability of the two groups were compared before treatment and 9 weeks after treatment. Results: There was no statistically significant difference between the study group and the control group in terms of ankle function scores and ability to perform activities of daily living before treatment (P > 0.05), but the difference was statistically significant after treatment (P < 0.05). Conclusion: Ultrasound can be used as a supplement to magnetic resonance imaging (MRI) of the ankle joint for diagnosing anterior talofibular ligament injury;ultrasound can show the location, distance, and degree of tear of the anterior talofibular ligament rupture and accurately predict muscle atrophy around the ankle joint;ultrasound combined with computed tomography (CT) can better determine the type of intra-articular fracture of the talar subtalar joint, and guide the choice of surgical timing. In addition, ultrasound can be used to determine the severity of peroneal muscle atrophy, assess the progress of early postoperative functional exercise, and guide personalized rehabilitation programs.

A lateral ankle sprain during a lateral backward step in badminton:A case report of a televised injury incident

Background:This study presents a kinematic analysis of an acute lateral ankle sprain incurred during a televised badminton match.The kinematics of this injury were compared to those of 19 previously reported cases in the published literature.Methods:Four camera views of an acute lateral ankle sprain incurred during a televised badminton match were synchronized and rendered in3-dimensional animation software.A badminton court with known dimensions was built in a virtual environment,and a skeletal model scaled to the inj ured athlete’s height was used for skeletal matching.The ankle joint angle and angular velocity profiles of this acute injury were compared to the summarized findings from 19 previously reported cases in the published literature.Results:At foot strike,the ankle joint was 2° everted,33° plantarflexed,and 18° internally rotated.Maximum inversion of 114° and internal rotation of 69° was achieved at 0.24 s and 0.20 s after foot strike,respectively.After the foot strike,the ankle joint moved from an initial position of plantarflexion to dorsiflexion-from 33° plantarflexion to 53° dorsiflexion(range=86°).Maximum inversion,dorsiflexion,and internal rotation angular velocity were 1262°/s,961°/s,and 677°/s,respectively,at 0.12 s after foot strike.Conclusion:A forefoot landing posture with a plantarflexed and internally rotated ankle joint configuration could incite an acute lateral ankle sprain injury in badminton.Prevention of lateral ankle sprains in badminton should focus on the control and stability of the ankle joint angle during forefoot landings,especially when the athletes perform a combined lateral and backward step.

An Improved Transosseous Pullout Suture Technique for Arthroscopic Repair of a Meniscus Root Tear

Objective:This study aimed to explore the clinical efficiency of an improved transosseous pullout suture technique for arthroscopic repair of a meniscus root tear.Methods:From January 2017 to January 2021,53 patients with posterior meniscus root tears combined with anterior cruciate ligament(ACL)and/or posterior cruciate ligament(PCL)tears were collected.Totally,in 29 patients(group A),the 2.0 mm modified pullout tunnel method was used to suture the posterior meniscus root,while 24 patients(group B)were treated with the traditional 4.5 mm pullout tunnel method.In group A,20 patients had lateral meniscus posterior root(LMPR)combined with ACL tears,5 patients had LMPR combined with ACL and PCL tears,and 4 patients had medial meniscus posterior root(MMPR)combined with ACL tears.In group B,19 patients had LMPR combined with ACL tears,3 patients had LMPR combined with ACL and PCL tears,and 2 patients had MMPR combined with ACL tears.The improvement of the Lysholm and VAS scores and the incidence of complications in group A and group B before the operation,1 month and 3 months after the operation,and after the final follow-up were compared.Results:Preoperative Lysholm score was 26.0±5.6 in group A and 26.7±5.8 in group B(P>0.05).One-month postoperative Lysholm score was 66.5±5.7 in group A and 54.3±2.4 in group B(P<0.001).Three-month postoperative Lysholm score was 81.1±7.2 in group A and 73.2±9.7 in group B(P<0.05).Lysholm scores after the final follow-up was 90.3±5.6 in group A and 90.0±5.0 in group B(P>0.05).Preoperative VAS score was 6.3±1.4 in group A and 6.3±1.2 in group B(P>0.05).One-month postoperative VAS score was 1.8±0.7 in group A and 2.4±0.9 in group B(P<0.05).Three-month postoperative VAS score was 0.7±0.6 in group A and 0.8±0.6 in group B(P>0.05).VAS score after the final follow-up was 0.2±0.4 in group A and 0.3±0.5 in group B(P>0.05).Conclusion:The improved transosseous pullout suture technique using a smaller 2.0 mm bone tunnel can virtually eliminate the risk of conflict with other bone tunnels and facilitate the management of bone tunnels in multiple ligament injuries,while also diminishing suture abrasion caused by the windshield wiper effect.The technique achieves good clinical efficacy.

Ankle Arthroscopy: A Complimentary Adjunct in the Diagnosis and Management of Ankle Fractures

Ankle fractures are one of the most common injuries treated by orthopaedic surgeons. A minority of patients with ankle fractures go on to develop persistent pain following anatomical reduction. These sequelae may arise as a result of untreated ligamentous or chondral injuries. This study aims to correlate acute arthroscopic ankle findings with the Lauge-Hansen fracture pattern classification. We further aim to compare subjective functional outcomes at least one year following surgery between patients who have received Open Reduction and Internal Fixation (ORIF) alone, versus ORIF plus arthroscopy. This is a retrospective case series of patients who have undergone ankle fracture ORIF +/- arthroscopy from July 2014 to July 2017 inclusive. Each patient’s presenting radiograph was classified according to the Lauge-Hansen ankle fracture classification with subsequent correlation to intra-operative arthroscopic findings. Functional outcome at a minimum of one year was evaluated with the American Academy of Orthopaedic Surgeons (AAOS) metric. Twenty two patients underwent ankle ORIF plus arthroscopy (Group A) with a further 26 patients receiving ORIF alone (Group B). 1 in 3 supination-external-rotation type II (SER II) injuries possessed a concomitant syndesmosis injury or osteochondral lesion (OCL) on arthroscopy. 1 in 3 patients with an SER IV injury had an osteochondral lesion. The mean AAOS score achieved for Group A was 89.6 (±7.9) with the mean score for Group B being 82.0 (±13.7). In conclusion, ankle arthroscopy aids the diagnosis and treatment of ligamentous and osteochondral injuries not evident on plain film with subsequent superior short-term outcomes.

Preseason elimination impact on anterior cruciate ligament injury in the national football league

BACKGROUND Anterior cruciate ligament(ACL)injuries represent detrimental injuries in the National Football League(NFL).A significant portion of these injuries often occur in preseason exhibitions.The Coronavirus disease 2019 pandemic presented a unique disruption to preseason NFL football with the cancelation of all preseason games.AIM To compare the incidence of ACL tears through the first eight weeks of the NFL season in 2020 to the mean incidence over the previous 5 seasons(2015-2019)and determine if there was any change in incidence with the elimination of the preseason.METHODS NFL players who suffered ACL tears during the preseason and first eight weeks of the NFL season from 2015-2020 were identified.The number of ACL injuries for the 2015-2019 seasons was compared to the 2020 season for four different timeframes.For each analysis,the cumulative number of ACL injuries to that time point was used to calculate the percent difference for descriptive analysis.Additionally,the number of teams with at least one player suffering an ACL tear were identified and compared using Chi-Squared testing.Finally,a cumulative relative risk was calculated for each week played.RESULTS There were 14 ACL tears through the first four games of the 2020 season,a 118.8%(14 vs 6.4)increase in comparison to the 5-year average over the first 4 regular season weeks of 2015-2019.However,when accounting for injuries occurring during the preseason from 2015-2019,there were 18.6%(14 vs 17.2)fewer total ACL injuries through regular season week 4 with no significant difference in percentage of teams impacted when these preseason injuries were accounted for P=0.394.Results were similar(19 vs 17.2)over 8 total games played(whether regular season or preseason),and over 8 regular season games(P=0.196,P=0.600).CONCLUSION The elimination of the NFL preseason resulted in a higher rate of injuries during the first 4 games of the regular season.However,these increases are offset by the injuries typically sustained during the preseason.This suggests there may be front-loading of injuries over the course of an NFL season,such that players may be more prone to injury when the intensity of play suddenly increases,whether in the preseason or regular season.

Research Progress of Anterior Cruciate Ligament Reconstruction under Arthroscopy

As an important means to treat anterior cruciate ligament (ACL) injury, the reconstruction technology under arthroscopy has made remarkable progress in recent years, evolving gradually from the early traditional open surgery to the minimally invasive surgery under full arthroscopy. At present, it is widely used. Different graft choices (such as autologous hamstring, peroneus longus, artificial tendon, and allogeneic tendon, etc.) and fixation methods (such as metal suspension fixation, interference screw, etc.) have their own characteristics. However, this technology still faces some challenges, such as postoperative complications and the long-term stability of the graft. In terms of future trends, it will develop in a more accurate and personalized direction. New materials and technologies are expected to emerge continuously to improve the surgical effect and the rehabilitation quality of patients, providing stronger support for clinical application and research. This article will conduct a comprehensive review from aspects such as surgical methods, graft selection, fixation methods, ligamentization of the graft, challenges faced, and future trends in ACL reconstruction surgery.

Closed patella fracture combined with cruciate ligament injury： a case control study

Background Patellar fracture and cruciate ligament injury are a common consequence of traumatic knee injury. Patellar fracture combined with cruciate ligament injury is rarely reported, although the mechanisms of two things are similar. This study aimed to evaluate the incidence of closed patella fracture combined with cruciate ligament injury.