Aims. Graft infection following anterior cruciate ligament reconstruction (ACLR) may lead to septic arthritis requiring multiple irrigation and debridement procedures, staged revision operations, and prolonged courses of antibiotics. To our knowledge, there are no previous studies reporting on how gentamicin pre-soaking of hamstring grafts influences infection rates following ACLR. We set out to examine this in our study accordingly. Methods. This retrospective study included 2,000 patients (1,156 males and 844 females) who underwent primary ACLR with
Tunnel enlargement after AC reconstruction with a
The purpose of our study is to determine if
Introduction. In order to prepare
Abstract. Background. The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft failure is the concern and ensuring a durable initial graft with rapid integration is crucial. Graft augmentation with implantable devices (internal brace reinforcement) is a technique purported to reduce the risk of rupture and hasten recovery. We aim to compare the short-term outcome of ACL-R using augmented hamstring tendon autografts (internally braced with neoligament) and non-augmented
The primary purpose of this study was to assess whether patients presenting with clinical graft laxity following primary anatomic anterior cruciate ligament (ACL) reconstruction using
AIMS. The aim of this study was to assess the knee function after MPFL reconstruction with single
The aim of the study was to assess the knee function after MPFL reconstruction with single
Post traumatic myositisossificans is a benign condition of heterotropic ossification of unknown aetiology which typically is related to trauma from a single blow or repeated episodes of microtrauma. We describe an unusual case of myositis ossificans which developed as a complication at the donor site for hamstring autologous graft used in open anterior and posterior cruciate repair and posterolateral corner reconstruction in a 15 year old girl. Case report: A 15 year old girl sustained a closed traumatic dislocation of her left knee when she fell from a trampoline. She underwent emergency manipulation under anaesthetic and closed reduction followed by MRI scan which showed a complete disruption of the lateral collateral ligament complex, posterolateral corner injury, complete tears of the anterior and posterior cruciate ligaments and a partial tear of the medial collateral ligament. 13 days later she had an open reconstruction of her anterior and posterior cruciate ligaments with allograft and a repair of popliteus and lateral structures with Larson reinforcement with controlateral hamstring autologous graft. Eight months following open reconstruction the patient represented to her primary care practitioner with a painful lump in the postero-medial controlateral right thigh. MRI study showed that there was a lobulated hypervascular appearance with a thin enhancing rim of low signal on all sequences indicating calcification. An xray revealed a calcified mass consistent with the diagnosis of myositis ossificans. Discussion and conclusion: To date we have found no reported cases of myositis ossificans occurring as a result of surgery to harvest
MRI has been suggested as an objective method of assessing anterior crucate ligament (ACL) graft “ligamentization” after reconstruction. It has been proposed that the MRI appearances could be used as an indicator of graft maturity and used as part of a return-to-sport assessment. The aim of this study was to evaluate the correlation between MRI graft signal and postoperative functional scores, anterior knee laxity, and patient age at operation. A consecutive cohort of 149 patients who had undergone semitendinosus autograft ACL reconstruction, using femoral and tibial adjustable loop fixations, were evaluated retrospectively postoperatively at two years. All underwent MRI analysis of the ACL graft, performed using signal-to-noise quotient (SNQ) and the Howell score. Functional outcome scores (Lysholm, Tegner, International Knee Documentation Committee (IKDC) subjective, and IKDC objective) were obtained and all patients underwent instrumented side-to-side anterior laxity differential laxity testing.Aims
Methods
Purpose: This study sought to examine return to sports in athletes younger than 25 following ACL reconstruction with either patellar tendon (PT) or
The gold standard treatment for Anterior Cruciate Ligament injury is reconstruction (ACL-R). Graft augmentation with suture tape (internal brace) are techniques purported to reduce the risk of rupture and hasten recovery. Our aim was to assess the short-term outcome of ACL-R using fibre tape augmented and non-augmented hamstring tendon grafts. This was a retrospective comparative study looking at augmented and non-augmented ACL-R. All procedures were performed by a single surgeon in a single centre using the same technique. The Knee injury and Osteoarthritis Outcome Score [KOOS] was used to assess patient-reported outcomes.Abstract
Background
Methods
Anterior cruciate ligament (ACL) injuries are among the most common and debilitating knee injuries in professional athletes with an incidence in females up to eight-times higher than their male counterparts. ACL injuries can be career-threatening and are associated with increased risk of developing knee osteoarthritis in future life. The increased risk of ACL injury in females has been attributed to various anatomical, developmental, neuromuscular, and hormonal factors. Anatomical and hormonal factors have been identified and investigated as significant contributors including osseous anatomy, ligament laxity, and hamstring muscular recruitment. Postural stability and impact absorption are associated with the stabilizing effort and stress on the ACL during sport activity, increasing the risk of noncontact pivot injury. Female patients have smaller diameter
Conclusions: At a midterm follow-up, reconstruction of the MPFL with rerouting of the semitendinosus tendon is an effective method with improved function in all patients. Maximum improvement was achieved within the first six postoperative months. Heterogeneity of our population may have affected some of our results.
Injury to the ACL is a significant problem and can cause further damage to the internal structures of the knee. ACL injury is associated with injuries to other structures in the knee such as the meniscus and chondral cartilage. Such intra articular injuries pre-dispose the knee to develop arthritis. This injury is usually seen in young and active people usually related to sporting injuries. There is a paucity of literature on the influence of anthropometric features on the hamstring graft obtained in ACL reconstruction, although there are studies on the sex based differences affecting the hamstring graft. This study was undertaken to assess the influence of anthropometric measurements on the graft thickness obtained at ACL reconstruction surgery within the UK population. This study was undertaken to assess the influence of anthropometric measurements (body mass index (BMI), height and weight) on the graft thickness obtained at anterior cruciate ligament reconstruction surgery.Background
Objective
We describe a new method for reconstructing the patellar tendon following combined injury to the patellar tendon and anterior cruciate ligament (ACL). Combined injuries to the patellar tendon and the ACL represent a rare and potentially serious injury pattern. The injury to the patellar tendon can often go undiagnosed at primary presentation. Reconstructive options for the patellar tendon are described but can be technically difficult, particularly if ipsilateral hamstring has been used for anterior cruciate ligament reconstruction. Evidence suggests combined injuries generally lead to poor long term outcome. We describe a case of a 26 year old male who presented with a reconstructed ACL and a patellar tendon deficient knee. Diagnosis was confirmed on Magnetic Resonance Imaging (MRI). Ipsilateral hamstrings had been used as donor for ACL reconstruction. An Achilles tendon allograft with distal bone block was used in combination with contralateral semitendinosus and gracilis autograft to reconstruct the three bundles of the patellar tendon. The patient experienced no postoperative complications and was followed up radiologically and clinically. Computer Topography imaging performed at 6 months post-operatively showed union of the bony Achilles tendon block. MRI performed 1 year post-operatively showed good incorporation of the tendinous grafts and no evidence of degeneration or tearing. Oxford knee score at 6 months post-operatively was 31/48. One year post-operatively full pre-injury activity level had been achieved. We believe this method to provide adequate strength and integrity, enabling early rehabilitation following this rare injury. It has also been shown to give a good functional outcome.
Bioabsorbable screws for anterior cruciate ligament reconstruction (ACLR) have been shown to be associated with femoral tunnel widening and cyst formation. To compare a poly-L-lactide–hydroxyapatite screw (PLLA-HA) with a titanium screw with respect to clinical and radiological outcomes over a 5 year period. 40 patients were equally randomized into 2 groups (PLLA-HA vs titanium) and ACLR performed with a 4 strand hamstring graft with femoral tunnel drilling via the anteromedial portal. Evaluation at 2 and 5 years was performed using the International Knee Documentation Committee assessment (IKDC), Lysholm knee score, KT 1000 arthrometer, single-legged hop test. Magnetic resonance imaging was used to evaluate tunnel and screw volume, ossification around the screws, graft integration and cyst formation. There was no difference in any clinical outcome measure at 2 or 5 years between the 2 groups. At 2 years, the PLLA-HA femoral tunnel was significantly smaller than the titanium screw tunnel (p=0.015) and at 5 years, there was no difference. At 2 years the femoral PLLA-HA screw was a mean 76% of its original volume and by 5 years, 36%. At 2 years the tibial PLLA-HA screw mean volume was 68% of its original volume and by 5 years, 46%. At 5 years, 88% of femoral tunnels and 56% of tibial tunnels demonstrated a significant ossification response. There was no increase in cyst formation in the PLLA-HA group and no screw breakages. The PLLA-HA screw provides adequate aperture fixation in ACLR with excellent functional outcomes. It was not associated with femoral tunnel widening or increased cyst formation when compared with the titanium screw. The resorbtion characteristics appear favourable and the hydroxyapatite component of the screw may stimulate osteoconduction, contributing to these results. The PLLA-HA screw is a good alternative to a titanium screw in ACLR, which may aid revision procedures and allow for imaging without artifact.
The aim of this study was to determine Anterior Cruciate Ligament (ACL) graft and contralateral ACL (CACL) survival in patients who have undergone ACL reconstruction (ACLR) with
To document and assess the available evidence regarding single bundle,
Aims. Our purpose was to describe an unusual series of 21 patients with fungal osteomyelitis after an anterior cruciate ligament reconstruction (ACL-R). Methods. We present a case-series of consecutive patients treated at our institution due to a severe fungal osteomyelitis after an arthroscopic ACL-R from November 2005 to March 2015. Patients were referred to our institution from different areas of our country. We evaluated the amount of bone resection required, type of final reconstructive procedure performed, and Musculoskeletal Tumor Society (MSTS) functional score. Results. A total of 21 consecutive patients were included in the study; 19 were male with median age of 28 years (IQR 25 to 32). All ACL-R were performed with