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In vitro performance of a biodegradable zinc alloy adjustable-loop cortical suspension fixation for anterior cruciate ligament reconstruction
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作者 Ting Wang Zhangzhi Shi +7 位作者 Hongyong Zhong Xiangmin Li Jinling Sun Wei Yin Xiaojing Ji Qiang Wang Anqi Zhao Luning Wang 《International Journal of Minerals,Metallurgy and Materials》 SCIE EI CAS CSCD 2024年第5期887-898,共12页
Anterior cruciate ligament(ACL)injuries of the knee are one of the most common and serious athletic injuries.The widely used cortical suspension fixation buttons for ligament reconstruction are permanent implants,part... Anterior cruciate ligament(ACL)injuries of the knee are one of the most common and serious athletic injuries.The widely used cortical suspension fixation buttons for ligament reconstruction are permanent implants,particularly those made from conventional steel or titanium alloys.In this study,a biodegradable Zn-0.45Mn-0.2Mg(ZMM42)alloy with the yield strength of 300.4 MPa and tensile strength of 329.8 MPa was prepared through hot extrusion.The use of zinc alloys in the preparation of cortical suspension fixation buttons was proposed for the first time.After 35 d of immersion in simulated body fluids,the ZMM42 alloy fixation buttons were degraded at a rate of 44μm/a,and the fixation strength was retained(379.55 N)in the traction loops.Simultaneously,the ZMM42 alloy fixation buttons exhibited an increase in MC3T3-E1 cell viability and high antibacterial activity against Escherichia coli and Staphylococcus aureus.These results reveal the potential of biodegradable zinc alloys for use as ligament reconstruction materials and for developing diverse zinc alloy cortical suspension fixation devices. 展开更多
关键词 anterior cruciate ligament reconstruction zinc alloy fixation buttons mechanical property corrosion behavior BIOCOMPATIBILITY
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Anterior cruciate ligament reconstruction:Effect of graft tunnel position on early to mid-term clinical outcomes
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作者 Oliver Mann Oday Al-Dadah 《World Journal of Orthopedics》 2024年第8期744-753,共10页
BACKGROUND Patient reported outcome measures(PROMs)can be used to assess knee function following anterior cruciate ligament(ACL)reconstruction.Intra-operatively,femoral and tibial tunnels are created to accommodate th... BACKGROUND Patient reported outcome measures(PROMs)can be used to assess knee function following anterior cruciate ligament(ACL)reconstruction.Intra-operatively,femoral and tibial tunnels are created to accommodate the new ACL graft.It is postulated that there is an optimum position and orientation of these tunnels and that outcomes from this procedure are affected by their position.AIM To evaluate the influence of graft tunnel position on early to mid-term clinical outcomes following ACL reconstruction.METHODS Six PROMs were collected following ACL reconstruction which included the Knee Injury and Osteoarthritis Outcome Score(KOOS),International Knee Documentation Committee,Lysholm,Tegner,EuroQol-5 Dimension-5 level,and Short Form 12-item Health Survey.A total of 8 radiological parameters were measured from post-operative X-rays relating to graft tunnel positions.This data was analysed to assess for any correlations between graft tunnel position and postoperative PROMs.RESULTS A total of 87 patients were included in the study with a mean post-operative follow-up of 2.3 years(range 1 to 7 years).Posterior position of tibial tunnel was associated with improved KOOS quality of life(rho=0.43,P=0.002)and EQ-5D VAS(rho=0.36,P=0.010).Anterior position of EndoButton femoral tunnel was associated with an improved EQ-5D index(rho=-0.38,P=0.028).There were no other significant correlations between any of the other radiological parameters and PROM scores.CONCLUSION Overall,graft tunnel position had very little correlation with clinical outcomes following ACL reconstruction.A few(posterior)tibial tunnel and(anterior)EndoButton femoral tunnel measurements were associated with better PROMs. 展开更多
关键词 anterior cruciate ligament reconstruction Patient reported outcome measures Graft tunnel X-ray Correlation
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Recurrent cyclops lesion after primary resection of fibroreactive nodule following anterior cruciate ligament reconstruction
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作者 Cadence Lee Farid Amirouche 《World Journal of Orthopedics》 2024年第6期495-497,共3页
In this case report featured in World Journal of Orthopedics,Kelmer et al describe a rare finding of a 28-year-old female patient who presented with a recurrent fibroreactive nodule 7 months following the resection of... In this case report featured in World Journal of Orthopedics,Kelmer et al describe a rare finding of a 28-year-old female patient who presented with a recurrent fibroreactive nodule 7 months following the resection of a primary cyclops lesion,suggesting recurrent cyclops syndrome.The patient had undergone an initial anterior cruciate ligament reconstruction for a non-contact right knee injury and reported successful recovery.Two years later,the patient sustained a repeat right knee injury followed by a positive McMurray test and acute pain with terminal extension.Arthroscopic synovectomy confirmed magnetic resonance imaging(MRI)finding of a cyclops lesion,which was surgically removed.Seven months postoperatively,the patient reported stiffness and difficulty with terminal extension.Repeat MRI indicated a recurrent cyclops lesion,which was surgically resected.Following resection of the second lesion,the patient underwent physical therapy and achieved full range of motion,maintaining complete recovery 19 months postoperatively.Recurrent cyclops lesions have rarely been reported in the literature,and this article is novel in its report of recurrent cyclops syndrome following a bone-patellar tendon-bone allograft.The presentation of this unusual finding exposes a need for further investigation of cyclops lesion pathology,which will aid its prevention and treatment. 展开更多
关键词 Cyclops lesion anterior cruciate ligament reconstruction Fibrous nodule Bone-patellar-tendon-bone allograft Cyclops syndrome
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Lateral femoral tunnel preparation and graft fixation for anterior cruciate ligament reconstruction–A discussion
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作者 Mehak Chandanani Andrea Volpin 《World Journal of Clinical Cases》 SCIE 2024年第17期3277-3280,共4页
This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft ... This article provides a discussion and commentary around the recent advances in arthroscopic anterior cruciate ligament reconstruction(ACLR),with a focus on the aspects of lateral femoral tunnel preparation and graft fixation techniques.The paper explores and comments on a recently published review by Dai et al,titled"Research progress on preparation of lateral femoral tunnel and graft fixation in ACLR",while providing insight into its relevance within the field of ACLR,and recommendations for future research. 展开更多
关键词 anterior cruciate ligament reconstruction Arthroscopic surgery Lateral femoral tunnel Graft fixation techniques anterior cruciate ligament tear BIOMECHANICS knee injuries
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Osteotomy combined with anterior cruciate ligament reconstruction for anterior cruciate ligament injury and biplanar deformity
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作者 Fu-Yuan Deng Jun-Cai Liu Zhong Li 《World Journal of Clinical Cases》 SCIE 2024年第22期4897-4904,共8页
BACKGROUND It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury,and varus deformity can aggravate the progression of medial osteoarthri... BACKGROUND It has been confirmed that the increased posterior tibial slope over 12 degrees is a risk factor for anterior cruciate ligament injury,and varus deformity can aggravate the progression of medial osteoarthritis.AIM To evaluate the efficacy of modified high tibial osteotomy(HTO)and anterior cruciate ligament reconstruction(ACLR)in the treatment of anterior cruciate ligament(ACL)injuries with varus deformities and increased posterior tibial slope(PTS)based on clinical and imaging data.METHODS The patient data in this retrospective study were collected from 2019 to 2021.A total of 6 patients were diagnosed with ACL injury combined with varus deformities and increased PTS.All patients underwent modified open wedge HTO and ACLR.The degree of correction of varus deformity and the PTS was evaluated by radiography and magnetic resonance imaging.RESULTS All 6 patients(6 knee joints)were followed up for an average of 20.8±3.7 months.The average age at surgery was 29.5±3.8 years.At the last follow-up,all patients resumed competitive sports.The International Knee Documentation Committee score increased from 50.3±3.1 to 87.0±2.8,the Lysholm score increased from 43.8±4.9 to 86±3.1,and the Tegner activity level increased from 2.2±0.7 to 7.0±0.6.The average movement distance of the tibia anterior translation was 4.8±1.1 mm,medial proximal tibial angle(MPTA)was 88.9±1.3°at the last follow-up,and the PTS was 8.4±1.4°,both of which were significantly higher than those before surgery(P<0.05).CONCLUSION Modified open wedge HTO combined with ACLR can effectively treat patients with ACL ruptures with an associated increased PTS and varus deformity.The short-term effect is significant,but the long-term effect requires further follow-up. 展开更多
关键词 anterior cruciate ligament reconstruction Varus deformity High tibial osteotomy Posterior tibial slope Biplanar deformity
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Cyclops syndrome following anterior cruciate ligament reconstruction: Can relapse occur after surgery?
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作者 Recep Öztürk 《World Journal of Orthopedics》 2024年第3期201-203,共3页
Symptomatic cyclops lesions are complications that can be seen at rates of up to approximately 10%after anterior cruciate ligament reconstruction.However,recurrent cyclops lesions have rarely been documented.There are... Symptomatic cyclops lesions are complications that can be seen at rates of up to approximately 10%after anterior cruciate ligament reconstruction.However,recurrent cyclops lesions have rarely been documented.There are case rare series in the literature regarding the treatment of recurrent cyclops lesion.Future large studies are needed to investigate factors contributing to the development of cyclops lesions and syndrome and treatment options. 展开更多
关键词 Cyclops lesion Cyclops syndrome anterior cruciate ligament knee arthroscopy Relaps
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Research progress on preparation of lateral femoral tunnel and graft fixation in anterior cruciate ligament reconstruction 被引量:1
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作者 Yue Dai Wen-Jie Gao +2 位作者 Wen-Chuan Li Xian-Xiang Xiang Wei-Ming Wang 《World Journal of Clinical Cases》 SCIE 2023年第35期8247-8255,共9页
Anterior cruciate ligament(ACL)injury is one of the most common types of sports injuries.People’s need to participate in sports and desire for a high quality of life promotes the continuous development of ACL reconst... Anterior cruciate ligament(ACL)injury is one of the most common types of sports injuries.People’s need to participate in sports and desire for a high quality of life promotes the continuous development of ACL reconstruction technology.Arthroscopic ACL reconstruction has been recognized as an effective method for the treatment of ACL injuries.This review analyses and summarizes the advantages and limitations of each surgical procedure for arthroscopic ACL reconstruction reported in the relevant literature so as to promote the future development of more relevant techniques. 展开更多
关键词 ARTHROSCOPY anterior cruciate ligament anterior cruciate ligament reconstruction Femoral tunnel Anatomical reconstruction
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Comparative study of the clinical efficacy of all-inside and traditional techniques in anterior cruciate ligament reconstruction 被引量:1
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作者 Bai-Jing An Yao-Ting Wang +2 位作者 Zhe Zhao Ming-Xin Wang Geng-Yan Xing 《World Journal of Clinical Cases》 SCIE 2023年第14期3195-3203,共9页
BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniq... BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction. 展开更多
关键词 anterior cruciate ligament reconstruction All-inside quadrupled semitendinosus Clinical curative effect Traditional hamstring tendon Visual analogue scale
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Demographic characteristics of patients who underwent anterior cruciate ligament reconstruction at a tertiary care hospital in India
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作者 Sai Krishna Mlv Asjad Mahmood +3 位作者 Pulak Vatsya Siva Srivastava Garika Ravi Mittal Manoj Nagar 《World Journal of Clinical Cases》 SCIE 2023年第15期3464-3470,共7页
BACKGROUND Anterior cruciate ligament(ACL)tears are common sports-related injuries.Their incidence is not the same either for all the sports or for the same sport across various nations.This information is maintained ... BACKGROUND Anterior cruciate ligament(ACL)tears are common sports-related injuries.Their incidence is not the same either for all the sports or for the same sport across various nations.This information is maintained by many sports leagues in their registries.However,very few nationwide registries exist for such injuries.This study is carried out to know the demographic characteristics of patients who underwent ACL reconstruction at our hospital in India.AIM To know the demographic characteristics of patients who underwent ACL reconstruction at a tertiary care hospital in India.METHODS All the patients who underwent ACL reconstruction from January 2020 to December 2021 were retrospectively studied.Patients with multi-ligament injuries or a history of previous knee surgery were excluded.The patients’history was obtained from the hospital records,they were interviewed telephonically,and online questionnaires were given.Their demographic data was analyzed and compared to the existing literature.RESULTS A total of 124 patients were operated on for ACL reconstruction during this period.The mean age of the patients was 27.97 years.One hundred and thirteen patients(91.1%)were male and 11(8.9%)were female.The majority of the patients(47.6%)sustained this injury by road traffic accidents(RTA)followed by sportsrelated injuries(39.5%).The commonest presenting complaint was giving way of the knee in 118 patients(95.2%).The mean duration from the injury to the first hospital visit among the patients was 290.1 d.The mean duration from the injury to surgery was 421.8 d.CONCLUSION ACL patients’demography is different in developing nations as compared to the developed world.RTA are the leading cause of ACL injuries and are followed by recreational sports as a cause.There is delayed access to healthcare leading to delayed diagnosis as well as even greater time to surgery.This,in turn,leads to poorer prognosis and longer rehabilitation.National registries for developing nations are the need of the hour due to the different demographics of ACL injuries in developing countries. 展开更多
关键词 anterior cruciate ligament Sports injury DEMOGRAPHY EPIDEMIOLOGY knee
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Assessment of functional prognosis of anterior cruciate ligament reconstruction in athletes based on a body shape index
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作者 Yun-Jun Wang Jun-Chang Zhang +1 位作者 Yu-Ze Zhang Ying-Hai Liu 《World Journal of Clinical Cases》 SCIE 2023年第19期4567-4578,共12页
BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relat... BACKGROUND A healthy body shape is essential to maintain athletes’sports level.At present,little is known about the effect of athletes’body shape on anterior cruciate ligament reconstruction(ACLR).Moreover,the relationship between body shape and variables such as knee joint function after operation and return to the field has not been well studied.AIM To verify the relationship between a body shape index(ABSI)and the functional prognosis of the knee after ACLR in athletes with ACL injuries.METHODS We reviewed 76 athletes with unilateral ACL ruptures who underwent ACLR surgery in the First Hospital of Shanxi Medical University between 2017 and 2020,with a follow-up period of more than 24 mo.First,all populations were divided into a High-ABSI group(ABSI>0.835,n=38)and a Low-ABSI group(ABSI<0.835,n=38)based on the arithmetic median(0.835)of ABSI values.The primary exposure factor was ABSI,and the outcome indicators were knee function scores as well as postoperative complications.The correlation between ABSI and postoperative knee function scores and postoperative complications after ACLR were analyzed using multifactorial logistic regression.RESULTS The preoperative knee function scores of the two groups were similar.The surgery and postoperative rehabilitation exercises,range of motion(ROM)compliance rate,Lysholm score,and Knee Injury and Osteoarthritis Outcome Score of the two groups gradually increased,whereas the quadriceps atrophy index gradually decreased.The knee function scores were higher in the Low-ABSI group than in the High-ABSI group at the 24-mo postoperative follow-up(P<0.05).In multifactorial logistic regression,ABSI was a risk factor of low knee joint function score after surgery,specifically low ROM scores(odds ratio[OR]=1.31,95%confidence interval[CI][1.10-1.44];P<0.001),low quadriceps atrophy index(OR=1.11,95%CI[0.97-1.29];P<0.05),low Lysholm scores(OR=2.34,95%CI[1.78-2.94];P<0.001),low symptoms(OR=1.14,95%CI[1.02-1.34];P<0.05),low activity of daily living(OR=1.34,95%CI[1.18-1.65];P<0.05),low sports(OR=2.47,95%CI[1.78-2.84];P<0.001),and low quality of life(OR=3.34,95%CI[2.88-3.94];P<0.001).ABSI was also a risk factor for deep vein thrombosis of the lower limb(OR=2.14,95%CI[1.88-2.36],P<0.05]and ACL recurrent rupture(OR=1.24,95%CI[0.98-1.44],P<0.05)after ACLR.CONCLUSION ABSI is a risk factor for the poor prognosis of knee function in ACL athletes after ACLR,and the risk of poor knee function after ACLR,deep vein thrombosis of lower limb,and ACL recurrent rupture gradually increases with the rise of ABSI. 展开更多
关键词 A body shape index anterior cruciate ligament reconstruction ATHLETES Multifactorial logistic regression OBESITY
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Effect of suspension training on neuromuscular function, postural control, and knee kinematics in anterior cruciate ligament reconstruction patients 被引量:4
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作者 Dong-Dong Huang Liang-Hua Chen +4 位作者 Zhe Yu Quan-Jun Chen Jie-Nuan Lai Hai-Hong Li Gang Liu 《World Journal of Clinical Cases》 SCIE 2021年第10期2247-2258,共12页
BACKGROUND Suspension training(SET)is a method of neuromuscular training that enables the body to carry out active training under unstable support through a suspension therapy system.However,there have been few report... BACKGROUND Suspension training(SET)is a method of neuromuscular training that enables the body to carry out active training under unstable support through a suspension therapy system.However,there have been few reports in the literature on the application of SET to anterior cruciate ligament reconstruction(ACLR)patients.It is not clear what aspects of the patient's function are improved after SET.AIM To investigate the effect of SET on the neuromuscular function,postural control,and knee kinematics of patients after ACLR surgery.METHODS Forty participants were randomized to an SET group or a control group.The SET group subjects participated in a SET protocol over 6 wk.The control group subjects participated in a traditional training protocol over 6 wk.Isokinetic muscle strength of the quadriceps and hamstrings,static and dynamic posture stability test,and relative translation of the injured knee were assessed before and after training.RESULTS The relative peak torque of the quadriceps and hamstrings in both groups increased significantly(P<0.001),and the SET group increased by a higher percentage than those in the control group(quadriceps:P=0.004;hamstrings:P=0.011).After training,both groups showed significant improvements in static and dynamic posture stability(P<0.01),and the SET group had a greater change than the control group(P<0.05).No significant improvement on the relative translation of the injured knee was observed after training in either group(P>0.05).CONCLUSION Our findings show that SET promotes great responses in quadriceps and hamstring muscle strength and balance function in ACLR patients. 展开更多
关键词 anterior cruciate ligament reconstruction Suspension training Neuromuscular function Postural control knee kinematics REHABILITATION
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Interspace between the Popliteal Artery and the Capsule of the Knee (IPACK) Block for Anterior Cruciate Ligament Reconstruction Surgery: A Two Case Series 被引量:1
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作者 Agnes Huang Prit Anand Singh Kwee Lian Woon 《Open Journal of Anesthesiology》 2020年第4期134-143,共10页
This case series describes the use of Interspace between the Popliteal Artery and the Capsule of the Knee (IPACK) block to provide motor-sparing analgesia for two consecutive patients undergoing anterior cruciate liga... This case series describes the use of Interspace between the Popliteal Artery and the Capsule of the Knee (IPACK) block to provide motor-sparing analgesia for two consecutive patients undergoing anterior cruciate ligament reconstruction (ACLR) by the same surgeon. Case 1 demonstrates the use of a proximal IPACK block as a post-operative rescue block for a patient who still experienced severe pain despite having received a femoral nerve block and parenteral opioids. Case 2 describes the use of a modified IPACK block as part of a multimodal approach with opioid and motor sparing effects. In both cases, the IPACK block provided satisfactory pain relief in the immediate postoperative period without motor weakness, making it an effective analgesic method for day surgery. With the IPACK block shown to be an effective nerve block for ACLR, we explore other advantages, limitations and further research required to better define the role of this block. 展开更多
关键词 IPACK anterior cruciate ligament reconstruction
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Recurrent cyclops lesion after primary anterior cruciate ligament reconstruction using bone tendon bone allograft:A case report 被引量:2
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作者 Grayson Kelmer Andrea H Johnson +1 位作者 Justin J Turcotte Daniel E Redziniak 《World Journal of Orthopedics》 2023年第11期836-842,共7页
BACKGROUND Cyclops lesions are a known complication of anterior cruciate ligament(ACL)reconstruction,with symptomatic cyclops syndrome occurring in up to 11%of surgeries.Recurrent cyclops lesions have been rarely docu... BACKGROUND Cyclops lesions are a known complication of anterior cruciate ligament(ACL)reconstruction,with symptomatic cyclops syndrome occurring in up to 11%of surgeries.Recurrent cyclops lesions have been rarely documented;this case study documents the successful treatment of a recurrent cyclops lesion.CASE SUMMARY A 28-year-old female presented following a non-contact injury to the right knee.Workup and clinical exam revealed an ACL tear,and arthroscopic reconstruction was performed.Two years later a cyclops lesion was discovered and removed via arthroscopic synovectomy.Seven months postoperatively,the patient presented with pain,stiffness,and difficulty achieving terminal extension.A smaller recurrent cyclops lesion was diagnosed,and a repeat synovectomy was performed.The patient recovered fully.CONCLUSION To the best of our knowledge,this is the first documented case of recurrent cyclops lesion after bone-patellar tendon-bone allograft ACL reconstruction presenting as cyclops syndrome. 展开更多
关键词 anterior cruciate ligament Cyclops lesion Cyclops syndrome knee arthroscopy anterior cruciate ligament reconstruction Case report
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Anatomical Risk Factors for Rupture of the Anterior Cruciate Ligament:Magnetic Resonance Imaging Based Knee Joint Assessment 被引量:1
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作者 Odile Fernande Zeh Mathurin Neossi Guena +5 位作者 Michele Petronille Ndem Nyamfoum Julienne Onguene Medza Derek Dangoh Ndangoh Claude Sandra Raissa Abomo Ngodo Maxwell Goudjou Sandjong Joseph Gonsu Fotsin 《Open Journal of Radiology》 2017年第4期228-240,共13页
Anterior cruciate ligament (ACL) rupture is one of the most frequently encountered traumatic ligamentous lesions of the knee. Several intrinsic and extrinsic factors are linked to this lesion. Anatomical factors incre... Anterior cruciate ligament (ACL) rupture is one of the most frequently encountered traumatic ligamentous lesions of the knee. Several intrinsic and extrinsic factors are linked to this lesion. Anatomical factors increase the anterior translation of the knee and thus promote the stretching and rupture of the anterior cruciate ligament. Objectives: To determine the anatomical risk factors favouring ACL rupture by comparing morphometric parameters of patients with knee ACL rupture to patients without ACL rupture, as well as the intercondylar notch index and the tibial slopes of the two groups and describing the ruptured ACLs and associated signs. Materials and Methods: We conducted a case-control descriptive analytical study in imaging centres of the General Henri Mondor of Aurillac Hospital Centre in France (CHM) and the Jordan Medical Centre of Yaoundé in Cameroon (CMJ). MRI exam protocols included T1 SE, T2 SE, proton density and Fat Sat sequences, with slices in all three planes. Morphometry knee variables measured in our study were: intercondylar notch index and the tibial slopes. These measurements were obtained from images stored in DICOM format and post processing software OsiriX MD&reg;for CMJ patients and Explore&reg;for CHM patients. Results: The study included 92 individuals, 38 in the case group and 54 in the control group. The mean age was 36.6 years for both groups;35.5 years for the cases and 37.4 years for the controls. The sex ratio was 1.87 men for 1 woman in both groups;2.16 men for 1 woman for the case group. 53% of ACL ruptures are partial, with the predominant direct sign being morphologic and signal abnormalities of the ACL. The most significant indirect sign of ACL rupture was mirror-image bone contusion that was observed in 47.3% of cases. In the case group, the mean lateral tibial slope was 4.003&deg;, whereas it was 2.92&deg;in the control group. The comparison of means was estimated at approximately 0.039 (p Conclusion: The increase in the lateral tibial slope was a risk factor for anterior cruciate ligament rupture in our study population. Intercondylar notch index and medial tibial slope did not show any statistical significant difference. 展开更多
关键词 Anatomical Factors anterior cruciate ligament Rupture MRI of the knee
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Five Strand Hamstring Tendon Autograft for Anterior Cruciate Ligament Reconstruction Provides No Benefit over the Gold Standard Four Strand Repair for Anterior Stability of the Knee: A Prospective Cohort Study
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作者 A.Sideris A.Hamze +2 位作者 N.Bertollo D.Broe WR Walsh 《Open Journal of Orthopedics》 2017年第6期156-172,共17页
The Four-Strand Hamstring Tendon Autograft has been long established as the gold standard for surgical reconstruction of the Anterior Cruciate Ligament. Some studies have suggested wider grafts, such as a Five-Strand ... The Four-Strand Hamstring Tendon Autograft has been long established as the gold standard for surgical reconstruction of the Anterior Cruciate Ligament. Some studies have suggested wider grafts, such as a Five-Strand hamstring graft, may provide greater strength and a larger scaffold for incorporation of the graft into the bone tunnels, leading to greater postoperative anterior stability of the knee. 28 (n = 18 Four-Strand and n = 10 Five-Strand) patients with planned ACL reconstructive surgery by a single surgeon were recruited for this study. The KT-1000 Arthrometer (MED metric, CA, USA) was used to quantify AP translation in the subjects’ knees before (T0) and after surgery at 6 (T1) and 12 (T2) weeks. At 12 weeks there was significantly higher (p = 0.01) mean anterior laxity on Maximum Manual Test in the Five- Strand group (9.1 ± 1.7 mm) than the Four Strand Group (6.9 ± 2.3 mm). Further, there were significantly higher mean side-to-side differences (p = 0.01) on Maximum Manual Test in the Five-Strand cohort (5.1 ± 3.5 mm) compared to the Four-Strand cohort (1.9 ± 2.2 mm). A significantly larger positive mean change in anterior laxity (p = 0.02) from 6 - 12 weeks was evident in the Five-Strand group (1.4 ± 0.9) than the Four-Strand group (-0.3 ± 1.9 mm). No significant correlations were seen between graft widths and measures of anterior stability on KT-1000. This study illustrated that there was no benefit to using a Five-Strand Hamstring Tendon Autograft when compared to the gold standard Four-Strand Repair specifically with regards to anterior stability of the knee. 展开更多
关键词 anterior cruciate ligament ACL anterior cruciate ligament Reconstructive Surgery anterior cruciate ligament reconstruction ACL reconstruction Five STRAND HAMSTRING Tendon AUTOGRAFT Four STRAND HAMSTRING Tendon AUTOGRAFT KT-1000 AP Translation knee
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Anterior cruciate ligament reconstruction best practice: A review of graft choice 被引量:15
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作者 Daniel A Shaerf Philip S Pastides +1 位作者 Khaled M Sarraf Charles A Willis-Owen 《World Journal of Orthopedics》 2014年第1期23-29,共7页
There is much literature about differing grafts used in anterior cruciate ligament(ACL) reconstruction. Much of this is of poor quality and of a low evidence base. We review and summarise the literature looking at the... There is much literature about differing grafts used in anterior cruciate ligament(ACL) reconstruction. Much of this is of poor quality and of a low evidence base. We review and summarise the literature looking at the four main classes of grafts used in ACL reconstruction; bone-patella tendon-bone, hamstrings, allograft and synthetic grafts. Each graft has the evidence for its use reviewed and then compared, where possible, to the others. We conclude that although there is no clear "best" graft, there are clear differences between the differing graft choices. Surgeon's need to be aware of the evidence behind these differences, in order to have appropriate discussions with their patients, so as to come to an informed choice of graft type to best suit each individual patient and their requirements. 展开更多
关键词 anterior cruciate ligament reconstruction HAMSTRING Patella TENDON ALLOGRAFT AUTOGRAFT Synthetic Bone-patella tendon-bone
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Biomechanics of the anterior cruciate ligament:Physiology,rupture and reconstruction techniques 被引量:9
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作者 Christoph Domnick Michael J Raschke Mirco Herbort 《World Journal of Orthopedics》 2016年第2期82-93,共12页
The influences and mechanisms of the physiology,rupture and reconstruction of the anterior cruciate ligament(ACL)on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies ov... The influences and mechanisms of the physiology,rupture and reconstruction of the anterior cruciate ligament(ACL)on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades.The knee is a complex joint with shifting contact points,pressures and axes that are affected when a ligament is injured.The ACL,as one of the intra-articular ligaments,has a strong influence on the resulting kinematics.Often,other meniscal or ligamentous injuries accompany ACL ruptures and further deteriorate the resulting kinematics and clinical outcomes.Knowing the surgical options,anatomic relations and current evidence to restore ACL function and considering the influence of concomitant injuries on resulting kinematics to restore full function can together help to achieve an optimal outcome. 展开更多
关键词 BIOMECHANICS anterior cruciate ligament joint pressure anterior cruciate ligament RUPTURE graft fixation anterior cruciate ligament reconstruction
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Anterior cruciate ligament reconstruction and knee osteoarthritis 被引量:4
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作者 Nikolaos K Paschos 《World Journal of Orthopedics》 2017年第3期212-217,共6页
Anterior cruciate ligament(ACL)injury is a traumatic event that can lead to significant functional impairment and inability to participate in high-level sports-related activities.ACL reconstruction is considered the t... Anterior cruciate ligament(ACL)injury is a traumatic event that can lead to significant functional impairment and inability to participate in high-level sports-related activities.ACL reconstruction is considered the treatment of choice for symptomatic ACL-deficient patients and can assist in full functional recovery.Furthermore,ACL reconstruction restores ligamentous stability to normal,and,therefore,can potentially fully reinstate kinematics of the knee joint.As a consequence,the natural history of ACL injury could be potentially reversed via ACL reconstruction.Evidence from the literature is controversial regarding the effectiveness of ACL reconstruction in preventing the development of knee cartilage degeneration.This editorial aims to present recent highlevel evidence in an attempt to answer whether ACL injury inevitably leads to osteoarthritis and whether ACL reconstruction can prevent this development or not. 展开更多
关键词 anterior cruciate ligament OSTEOARTHRITIS anterior cruciate ligament reconstruction Prevention of OSTEOARTHRITIS MENISCUS TEAR anterior cruciate ligament TEAR
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Technical note: Anterior cruciate ligament reconstruction in the presence of an intramedullary femoral nail using anteromedial drilling 被引量:1
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作者 Matthew Lacey Joseph Lamplot +2 位作者 Kempland C Walley Joseph P De Angelis Arun J Ramappa 《World Journal of Orthopedics》 2017年第5期379-384,共6页
AIM To describe an approach to anterior cruciate ligament(ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary(IM) femoral nail.METHODS Once preop... AIM To describe an approach to anterior cruciate ligament(ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary(IM) femoral nail.METHODS Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware(locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology. The ACL remnant and lateral wall soft tissues are removed from the intercondylar, to provide adequate visualization of the ACL footprint. Femoral tunnel placement is performed using a transportal ACL guide with desired offset and the knee flexed to 2.09 rad. The Beath pin is placed through the guide starting at the ACL's anatomic footprint using arthroscopic visualization and/or fluoroscopic guidance. If resistance is met while placing the Beath pin, the arthroscopy should be discontinued and the obstructing hardware should be removed under fluoroscopic guidance. When the Beath pin is successfully placed through the lateral femur, it is overdrilled with a 4.5 mm Endobutton drill. If the Endobutton drill is obstructed, the obstructing hardware should be removed under fluoroscopic guidance. In this case, the obstruction is more likely during Endobutton drilling due to its larger diameter and increased rigidity compared to the Beath pin. The femoral tunnel is then drilled using a best approximation of the graft's outer diameter. We recommend at least 7 mm diameter to minimize the risk of graft failure. Autologous hamstring grafts are generally between 6.8 and 8.6 mm in diameter. After reaming, the knee is flexed to 1.57 rad, the arthroscope placed through the anteromedial portal to confirm the femoral tunnel position, referencing the posterior wall and lateral cortex. For a quadrupled hamstring graft, the gracilis and semitendinosus tendons are then harvested in the standard fashion. The tendons are whip stitched, quadrupled and shaped to match the diameter of the prepared femoral tunnel. If the diameter of the patient's autologous hamstring graft is insufficient to fill the prepared femoral tunnel, the autograft may be supplemented with an allograft. The remainder of the reconstruction is performed according to surgeon preference. RESULTS The presence of retained hardware presents a challenge for surgeons treating patients with knee instability. In cruciate ligament reconstruction, distal femoral and proximal tibial implants hardware may confound tunnel placement, making removal of hardware necessary, unless techniques are adopted to allow for anatomic placement of the graft. CONCLUSION This report demonstrates how the femoral tunnel can be created using the anteromedial portal instead of a transtibial approach for reconstruction of the ACL. 展开更多
关键词 Anteromedial DRILLING INTRAMEDULLARY FEMORAL NAIL anterior cruciate ligament reconstruction RETAINED hardware
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Estimates of voluntary activation in individuals with anterior cruciate ligament reconstruction:Effects of type of stimulator,number of stimuli,and quantification technique
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作者 Steven A.Garcia Kazandra M.Rodriguez +2 位作者 Scott R.Brown Riann M.Palmieri-Smith Chandramouli Krishnan 《Journal of Sport and Health Science》 SCIE 2022年第1期85-93,共9页
Background:Accurate quantification of voluntary activation is important for understanding the extent of quadriceps dysfunction in individuals with anterior cruciate ligament reconstruction(ACLR).Voluntary activation h... Background:Accurate quantification of voluntary activation is important for understanding the extent of quadriceps dysfunction in individuals with anterior cruciate ligament reconstruction(ACLR).Voluntary activation has been quantified using both percent activation derived from the interpolated twitch technique and central activation ratio(CAR)derived from the burst superimposition technique,as well as by using different types of electrical stimulators and pulse train conditions.However,it is unclear how these parameters affect voluntary activation estimates in individuals with ACLR.This study was performed to fill this important knowledge gap in the anterior cruciate ligament literature.Methods:Quadriceps strength and voluntary activation were examined in 18 ACLR participants(12 quadriceps/patellartendon graft,6 hamstring tendon graft;time since ACLR:1.06±0.82 years,mean±SD)at 90°of knee flexion using 2 stimulators(Digitimer and Grass)and pulse train conditions(3-pulse and 10-pulse).Voluntary activation was quantified by calculating both CAR and percent activation.Results:Results indicated that voluntary activation was significantly overestimated by CAR when compared with percent activation(p<0.001).Voluntary activation estimates were not affected by pulse train conditions when using percent activation;however,3-pulse stimuli resulted in greater overestimation than 10-pulse stimuli when using CAR(p=0.003).Voluntary activation did not differ between stimulators(p>0.05);however,the Digitimer evoked greater torque at rest than the Grass(p<0.001).Conclusion:These results indicate that percent activation derived from the interpolated twitch technique provides superior estimates of voluntary activation than CAR derived from burst superimposition and is less affected by pulse train conditions or stimulators in individuals with ACLR. 展开更多
关键词 anterior cruciate ligament Central activation Inhibition knee strength TRIPLET Twitch interpolation
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