BACKGROUND The anterior cruciate ligament-deficient knee is prone to osteoarthritis and meniscus lesions. Very little, however, is known about the biomechanical properties of articular cartilage in anterior cruciate ligament-deficient knees. PURPOSE To evaluate biomechanical and macroscopical cartilage changes in the knee joint with respect to the time after anterior cruciate ligament rupture. HYPOTHESIS Chronic anterior cruciate ligament deficiency induces cartilage softening. STUDY DESIGN Cross-sectional study; Level of evidence, 3. METHODS Cartilage stiffness of 50 patients undergoing anterior cruciate ligament reconstructive surgery because of symptomatic knee instability after chronic anterior cruciate ligament rupture was measured with an arthroscopic indenter device, and the number and size of cartilage lesions were evaluated. RESULTS The cartilage stiffness did not correlate with time from trauma to surgery (r = 0.002, P = .99), but the number of cartilage lesions in the knee increased
TY - JOUR. T1 - Effects of neuromuscular electrical stimulation after anterior cruciate ligament reconstruction on quadriceps strength, function, and patient-oriented outcomes. T2 - A systematic review. AU - Kim, Min. AU - Croy, Ted. AU - Hertel, Jay. AU - Saliba, Susan. PY - 2010/1/1. Y1 - 2010/1/1. N2 - Study Design: Systematic Literature review. Objective: To perform a systematic review of randomized controlled trials assessing the effects of neuromuscular electrical stimulation (NMES) on quadriceps strength, functional performance, and self-reported function after anterior cruciate ligament reconstruction. Background: Conflicting evidence exists regarding the effectiveness of NMES following anterior cruciate ligament reconstruction. Methods: Searches were performed for randomized controlled trials using electronic databases from 1966 through October 2008. Methodological quality was assessed using the Physiotherapy Evidence Database Scale. Between- group effect sizes and 95% confidence ...
Arthroscopic anterior cruciate ligament reconstruction using the double press- fit technique: an alternative to interference screw fixation.: The double press-f
Background: The ACL is the primary restrain to anterior translation of the tibia on the femur. The present study was conducted to assess cases of anterior cruciate ligament reconstruction surgery in adult patients.Subjects and Methods:The present study was conducted on 72 patients who underwent anterior cruciate ligament reconstruction surgery. Risk factors were recorded. Results:Out of 72 patients, males were 48 and females were 24. Out of 72 patients, infection was present in 10 males and 4 females. Risk factors for ACL surgery was BPTB graft in 3, STG graft in 5 cases. Obesity was seen in 11, smoking in 6, and diabetes mellitus in 4. The difference was significant (P, 0.05).Conclusion: ACL injury is common among sports person. Risk factors reported were diabetes mellitus, smoking and obesity.. ...
OBJECTIVE To determine the effect of graft choice (allograft, bone-patellar tendon-bone autograft, or hamstring autograft) on deep tissue infections following anterior cruciate ligament (ACL) reconstructions. DESIGN Retrospective cohort study. SETTING AND POPULATION Patients from 6 US health plans who underwent ACL reconstruction from January 1, 2000, through December 31, 2008. METHODS We identified ACL reconstructions and potential postoperative infections using claims data. A hierarchical stratified sampling strategy was used to identify patients for medical record review to confirm ACL reconstructions and to determine allograft vs autograft tissue implanted, clinical characteristics, and infection status. We estimated infection rates overall and by graft type. We used logistic regression to assess the association between infections and patients demographic characteristics, comorbidities, and choice of graft. RESULTS On review of 1,452 medical records, we found 55 deep wound infections. With ...
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Experimental and numerical analysis of screw fixation in anterior cruciate ligament reconstruction - -This paper reports the results of an experimental and finite element analysis of tibial screw fixation in hamstring ACL reconstruction. The mechanical properties of the bone and tendon graft are obtained from experiments using porcine/calf bones and tendon. The results of the numerical study are compared with those from mechanical testing. Analysis shows that the model may be used to establish the optimum placement of the tunnel in anterior cruciate ligament reconstruction by predicting mechanical parameters such as stress, strain and displacement at regions in the tunnel wall.
0005]Single tunnel single bundle anterior cruciate ligament reconstruction (STSBACLR) has long been established as a method of anterior cruciate ligament (ACL) reconstruction. A variety of graft choices are available to surgeons during ACL reconstruction. These choices include autogenous patellar or quadriceps tendon with bone blocks, or hamstring tendons. In addition, changed here tendon allografts (from donors) may be used. The main portion of the ACL which needs to be reconstructed is the anterolateral bundles. Arthroscopic assisted or open ACL reconstructions involve removing the remaining native ACL and drilling a tunnel at the anatomic attachment site of the anterolateral or posterior medial bundle at the anterolateral wall of the intercondylar notch. This tunnel is drilled in line with the roof of the notch and about 1-3 mm from the posterior articular surface of the lateral femoral condyle. The tibial attachment site is then prepared by identifying the normal attachment site of the ACL ...
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TY - JOUR. T1 - Anterior cruciate ligament reconstruction. T2 - A literature review of the anatomy, biomechanics, surgical considerations, and clinical outcomes. AU - Beasley, Leslie S.. AU - Weiland, Daniel E.. AU - Vidal, Armando F.. AU - Chhabra, Anikar. AU - Herzka, Andrea S.. AU - Feng, Matthew T.. AU - West, Robin V.. PY - 2005/1. Y1 - 2005/1. N2 - Anterior cruciate ligament (ACL) ruptures are some of the most common knee injuries seen by sports medicine physicians. However, given the complex anatomy and function of the ACL, reconstruction of this ligament is anything but straightforward. The last decade has seen much advancement in ACL reconstruction, with an improved knowledge of the biology and biomechanics of graft incorporation, new choices for graft material and graft fixation devices, and more accelerated rehabilitation protocols. Although there are numerous studies in the literature on ACL reconstruction, there is yet to be a consensus among surgeons on the "best" graft choice and ...
TY - JOUR. T1 - Incidence of Second Anterior Cruciate Ligament Tears (1990-2000) and Associated Factors in a Specific Geographic Locale. AU - Schilaty, Nathan. AU - Bates, Nathaniel A.. AU - Sanders, Thomas L.. AU - Krych, Aaron. AU - Stuart, Michael J.. AU - Hewett, Timothy. PY - 2017/6/1. Y1 - 2017/6/1. N2 - Background: Second anterior cruciate ligament (ACL) tears after reconstruction occur at a reported rate of 20% to 30%. This high frequency indicates that there may be factors that predispose an athlete to graft failure and ACL tears of the contralateral knee. Purpose: To determine the incidence of second ACL injuries in a geographic population-based cohort over a 10-year observation period. Study Design: Descriptive epidemiological study. Methods: International Classification of Diseases, 9th Revision (ICD-9) codes relevant to the diagnosis of an ACL tear and the procedure code for ACL reconstruction were searched across the Rochester Epidemiology Project, a multidisciplinary county ...
TY - JOUR. T1 - Characterization of biochemical cartilage change after anterior cruciate ligament injury using T1ρ mapping magnetic resonance imaging. AU - Osaki, Kanji. AU - Okazaki, Ken. AU - Takayama, Yukihisa. AU - Matsubara, Hirokazu. AU - Kuwashima, Umito. AU - Murakami, Koji. AU - Doi, Toshio. AU - Matsuo, Yoshio. AU - Honda, Hiroshi. AU - Iwamoto, Yukihide. PY - 2015/1/1. Y1 - 2015/1/1. N2 - Background: Patients with anterior cruciate ligament (ACL)-injured knees are at an increased risk of posttraumatic osteoarthritis (OA). OA changes secondary to ACL injuries have many variations, and when and where early cartilage degenerative change begins has not yet been established. Purpose: To characterize the location of cartilage degeneration after ACL injury associated with time since injury using T1rho (T1ρ) mapping. Study Design: Cross-sectional study; Level of evidence, 3. Methods: In this study, 49 knees with ACL injuries and 14 normal knees from uninjured volunteers were imaged with a ...
PhD Completion Seminar - Corticomotor and biomechanical adaptations following anterior cruciate ligament rupture and reconstruction page in the Melbourne School of Health Sciences site.
An anterior cruciate ligament reconstruction is an operation to replace a damaged anterior cruciate ligament with a ligament graft or a synthetic ligament.
Introduction : Several studies have suggested that anterior cruciate ligament reconstruction (ACLR) without wound drainage has no impact on long-term follow-up. Aim: To investigate a prospective patient series as measured by the patient-administered disease-specific questionnaire Knee...
Anterior cruciate ligament tear. Coloured computer tomography (CT) scan of the knee joint of a patient with a tear of the anterior cruciate ligament (ACL). This ligament is one of the four major ligaments holding the knee joint together, joining the femur (thigh bone, top) and the tibia (bottom). Injuries to this ligament are a relatively common sporting injury, and surgery is needed to restore full function to the knee. Here, the injured area is the light pink area (centre right) between the ends of the two bones (dark red). - Stock Image C007/4096
Anterior Cruciate Ligament Tear Introduction The Anterior Cruciate Ligament (ACL) is the most commonly injured ligament of the knee. The ligament is most commonly injured during an athletic activity. Due
The purpose of the current analysis was to determine which PNMT exercises had a greater prophylactic effect in clinical trials that aimed to reduce ACL injury in young females. Four exercise categories, balance, plyometrics, strength and proximal control training, were examined. The results indicated that clinical trials that instituted PNMT with strength and proximal control training demonstrated the greatest prophylactic effects. Prophylactic effects were not statistically different between PNMT with and without plyometrics, but greater ACL injury reduction was recorded in PNMT with plyometrics. More specifically, incorporating plyometrics, strengthening and proximal control training into PNMT programmes can lead to ACL injury risk reduction by 61% in plyometrics, 68% in strengthening, and 67% in proximal control in young females. Balance exercises demonstrated a 41% reduction in ACL injury rate compared to a 66% reduction by PNMT without balance exercises (figure 2).. Plyometric exercises in ...
The anterior cruciate ligament (ACL) is one of a pair of cruciate ligaments (the other being the posterior cruciate ligament) in the human knee. The two ligaments are also called cruciform ligaments, as they are arranged in a crossed formation. In the quadruped stifle joint (analogous to the knee), based on its anatomical position, it is also referred to as the cranial cruciate ligament. The anterior cruciate ligament is one of the four main ligaments of the knee, providing 85% of the restraining force to anterior tibial displacement at 30 degrees and 90 degrees of knee flexion. The ACL originates from deep within the notch of the distal femur. Its proximal fibers fan out along the medial wall of the lateral femoral condyle. There are two bundles of the ACL: the anteromedial and the posterolateral, named according to where the bundles insert into the tibial plateau. (The tibia plateau is a critical weight-bearing region on the upper extremity of the tibia). The ACL attaches in front of the ...
Knee strength deficits after hamstring tendon and patellar tendon anterior cruciate ligament reconstruction. Knee bracing after ACL reconstruction: effects on postural control and proprioception
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Ideal conditions for healing are mostly non-existent in one of the most common sports-related injury, the anterior cruciate ligament (ACL) tear.[1] Furthermore, there are still controversies in regards to the optimal management of a torn ACL and the optimal time for return to sports following ACL reconstruction.. At a mean of six months after ACL reconstruction, objective functional recovery of the knee was generally unsatisfactory and this seemed to be a risk factor for recurrent tears.[2] A systematic review and meta-analysis demonstrates that younger age and return to high level of activity are evident factors leading to recurrent ACL tears.[3] These combined data indicate that nearly one in four young athletic patients who sustain an ACL injury and return to high-risk sports will develop another ACL injury.[3]. The ACL reconstruction does not necessarily enable return to preinjury sports participation. By returning to pivoting sports after ACL reconstruction, athletes are also facing high ...
The hyperflexion required for femoral tunnel drilling in anterior cruciate ligament reconstruction can be challenging in patients with increased body habitus or musculature. Whilst allowing femoral tunnel creation without hyperflexion, additional benefits of flexible reamers have been proposed in terms of tunnel dimensions. The purpose of this study was to examine whether these theoretical benefits are seen in a clinical study ...
Background: Anterior cruciate ligament reconstructions (ACLRs) are frequently performed on young, active patients and can result in persistent knee symptoms and activity limitations that may affect health-related quality of life (HRQoL). To date, there has been no systematic review of HRQoL outcomes after ACLR. Purpose: The objectives of this study were to report HRQoL ≥5 years after ACLR, compare HRQoL outcomes with available population norms, and describe factors that may affect HRQoL in this population. Study Design: Systematic review. Methods: All studies reporting HRQoL ≥5 years after ACLR with hamstring or patellar tendon autografts were eligible for review. Common HRQoL outcomes were pooled using a random-effects meta-analysis and compared with published population norms. The Spearman rank correlation coefficient (r) was used to identify variables associated with HRQoL outcomes. Where insufficient data were available, outcomes were reported descriptively. Results: Fourteen studies ...
All-Inside Versus Inside-Out Meniscal Repair With Concurrent Anterior Cruciate Ligament Reconstruction: A Meta-regression Analysis .
Anatomy Image Organs: Femur Thigh Bone Anterior Cruciate Ligament Quadricap Tendon Anterior Cruciate Ligament Patellar Tendon Lateral Meniscus Knee Anatomy ...
Successful anterior cruciate ligament reconstruction with a tendon graft necessitates solid healing of the tendon graft in the bone tunnel. Improvement of graft healing to bone is crucial for facilitating an early and aggressive rehabilitation and ensuring rapid return to pre-injury levels activity. Tendon graft healing in a bone tunnel requires bone ingrowth into the tendon. Indirect Sharpey fiber formation and direct fibrocartilage fixation confer different anchorage strength and interface properties at the tendon-bone interface. For enhancing tendon graft-to-bone healing, we introduce a strategy that includes the use of periosteum, hydrogel supplemented with periosteal progenitor cells and bone morphogenetic protein-2, and a periosteal progenitor cell sheet. Future studies include the use of cytokines, gene therapy, stem cells, platelet-rich plasma, and mechanical stress for tendon-to-bone healing. These strategies are currently under investigation, and will be applied in the clinical setting in the
There is a greater risk of tibial component loosening when mobile unicompartmental knee replacement is performed in anterior cruciate ligament deficient knees. We previously reported on a cohort of anterior cruciate ligament deficient patients (n=46) who had undergone surgery, but no difference was found in implant survivorship at a mean 5-year follow-up. The purpose of this study was to examine the kinematic behaviour of a subcohort of these patients.The kinematic behaviour of anterior cruciate deficient knees (n=16) after mobile unicompartmental knee replacement was compared to matched intact knees (n=16). Sagittal plane knee fluoroscopy was taken while patients performed step-up and forward lunge exercises. The patellar tendon angle, knee flexion angle and implant position was calculated for each video frame.The patellar tendon angle was 5° lower in the deficient group, indicating greater anterior tibial translation compared to the intact group between 30 and 40° of flexion. Large variability,
Background:The main goal of physiotherapy for patients with anterior cruciate ligament reconstruction (ACL-R) is to improve postural control and retain knee function. Therefore, clinicians need to use evaluative tools that assess postural changes during physiotherapy. To maximize the clinical utility of the results of these tools, the extracted measures should have appropriate psychometric properties of reliability, validity and responsiveness. No study has yet addressed responsiveness of postural measures in these patients. This study was designed to investigate the responsiveness and determine the minimal clinically important changes (MCIC) of static and dynamic postural measures in patients with (ACL-R) following physiotherapy. Methods: Static and dynamic postural measures were evaluated at first occasion and again after four weeks physiotherapy. The static measures consisted of center of pressure (COP) parameters while dynamic measures included the stability indices. Correlation analysis and ROC
Background:The main goal of physiotherapy for patients with anterior cruciate ligament reconstruction (ACL-R) is to improve postural control and retain knee function. Therefore, clinicians need to use evaluative tools that assess postural changes during physiotherapy. To maximize the clinical utility of the results of these tools, the extracted measures should have appropriate psychometric properties of reliability, validity and responsiveness. No study has yet addressed responsiveness of postural measures in these patients. This study was designed to investigate the responsiveness and determine the minimal clinically important changes (MCIC) of static and dynamic postural measures in patients with (ACL-R) following physiotherapy. Methods: Static and dynamic postural measures were evaluated at first occasion and again after four weeks physiotherapy. The static measures consisted of center of pressure (COP) parameters while dynamic measures included the stability indices. Correlation analysis and ROC
Arthroscopy of the left knee was performed with the anterior cruciate ligament reconstruction. Removal of loose bodies. Medial femoral chondroplasty and
Where is the anterior cruciate ligament is located in the human body - Where is the anterior cruciate ligament is located in the human body? The knee. The anterior cruciate ligament is located directly in the center of the knee and is a major stabilizer of the knee joint.
Anterior Cruciate Ligament injuries are common knee injuries that need proper non-surgical and maybe surgical treatment. When an ACL injury occurs, the knee becomes less stable. Such instability will make sudden pivoting movements difficult. This type of damage to the knee may also make you prone to developing arthritis and cartilage tears.The symptoms of an ACL injury may include a sudden giving way of the knee, a
Sizer P, Sawyer S, Brismee J, Jones K*, Bruce J*, Slauterbeck J. The Effect of Microcurrent Stimulation on Postoperative Pain After Patellar Tendon-Bone Anterior Cruciate Ligament Reconstruction. Presented at the American Physical Therapy Association Annual Conference and Exposition, Indianapolis, Indiana; June, 2000.. PURPOSE: The purpose of this study was to determine the effectiveness of microcurrent electrical therapy in providing pain relief to a selected post-operative patient population.. SUBJECTS: Subjects were 19 females and 22 males (mean age of 21.1) who received arthroscopic bone-patellar tendon-bone anterior cruciate ligament (ACL) reconstruction.. METHODS AND MATERIALS: Subjects were randomly assigned to one of two treatment groups ("Microcurrent" or "Placebo" Groups) in a double blind experimental design. Using a portable microcurrent device (Alpha-Stim 100 by Electromedical Products International, Inc, Mineral Wells, Texas), the Microcurrent Group received 100 microamperes of ...
Semantic Scholar extracted view of Bicompartmental (medial and lateral) displaced bucket-handle meniscal tears with associated anterior cruciate ligament rupture. by Stephen A. Parada et al.
There are an estimated 80,000 to 100,000 anterior cruciate ligament (ACL) repairs in the United States each year. Most ACL tears occur from noncontact injuries. Women experience ACL tears up to nine times more often than men. Evaluation of the ACL should be performed immediately after an injury if possible, but is often limited by swelling and pain. When performed properly, a complete knee examination is more than 80 percent sensitive for an ACL injury. The Lachman test is the most accurate test for detecting an ACL tear. Magnetic resonance imaging is the primary study used to diagnose ACL injury in the United States. It can also identify concomitant meniscal injury, collateral ligament tear, and bone contusions. Treatment consists of conservative management or surgical intervention, with the latter being the better option for patients who want to return to a high level of activity. Patients who undergo surgery must commit to appropriate rehabilitation for the best outcome. Long-term sequelae of ACL
Dr Michael Ledger in Perth, WA offers knee surgery and treatments for patellar tendonitis and anterior cruciate ligament injuries.
Learn more about Anterior Cruciate Ligament Injury at Reston Hospital Center DefinitionCausesRisk FactorsSymptomsDiagnosisTreatmentPreventionrevision ...
Radiographic enlargement of bone tunnels following anterior cruciate ligament (ACL) reconstruction has been recently introduced in the literature; however, the etiology and clinical relevance of this
The aim of this study is to directly compare the clinical outcomes of both the celecoxib and placebo groups following anterior cruciate ligament (ACL) reconstruction. The study will have short and long term goals. Validated outcome measures will aim to quantify pain control at 2 weeks after surgery, as well as knee function at 2 year follow-up. Groups will be compared using pain control scales, and functional knee outcome scores. The first null hypothesis tested by this study is that the celecoxib group experiences equal pain control compared with the placebo group. The second null hypothesis is that no knee function difference will be found between the celecoxib and placebo groups ...
International Scholarly Research Notices is a peer-reviewed, Open Access journal covering a wide range of subjects in science, technology, and medicine. The journals Editorial Board as well as its Table of Contents are divided into 108 subject areas that are covered within the journals scope.
Examining the Effect of Anterior Drawer and Lachman Test on Lysholm Score in Patients with Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon
Examining the Effect of Anterior Drawer and Lachman Test on Lysholm Score in Patients with Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon
Reconstruction surgery of anterior cruciate ligament injury of the knee is done through endoscopic surgery called arthroscopic surgery.
BACKGROUND:In many centres patients are routinely referred for physiotherapy after anterior cruciate ligament (ACL) reconstruction. However, to date the role and amount of supervised physiotherapy required has not been clearly established. OBJECTIVE:To establish whether there was any difference in outcome between a group of patients who attended physiotherapy regularly after ACL reconstruction and a group who attended only infrequently. METHODS:Ten patients who had attended physiotherapy infrequently (mean 1.9 visits) during the first six months after ACL reconstructive surgery were matched for age, sex, graft type, and activity level and occupation before injury with 10 patients who had attended physiotherapy regularly (mean 26.5 visits). Outcome was assessed at 12 months using the Cincinnati knee rating system and the IKDC form. RESULTS:Compared with the regular physiotherapy group, patients in the minimal physiotherapy group had fewer symptoms (mean Cincinnati symptom score 46.2 v 43.4, p = ...
Athletes who have sustained an anterior cruciate ligament (ACL) injury often opt for an ACL reconstruction (ACLR) with the goal and expectation to resume sports. Unfortunately, the proportion of...
Background: The goal of this study is to provide outcomes data for ACL reconstruction surgeries to a single physician/surgeon and the patient. Outcomes data collected and analyzed for a single physician will provide the surgeon with information that can be given to patients seeking ACL reconstruction surgery. This information will help the patient know what to expect in terms of recovery, infection rate, and failure rate. It will also aid the surgeon in identifying areas of strength and weakness in his practice. To accomplish this goal a database was created using Filemaker Pro 7 software that allows for data entry at the point of care and basic data analysis. The analyzed data will be given to ACL reconstruction surgery candidates likely in the form of a handout or pamphlet during the informed consent process. Hypothesis: Collection of subjective and objective data should allow for a better understanding of the post-operative outcomes of a single surgeon for ACL reconstruction surgery and improve the
During 2000-2015, the incidence of ACL reconstruction surgery increased in Australia in all age groups; the overall incidence was greatest among 15-24-year-olds. Consistent with other recent reports,1,3,17 the rate of growth in incidence was greatest among 5-14-year-old children.. Our calculated primary ACL reconstruction incidence of 77.4 per 100 000 population is the highest population-adjusted rate in the world; lower rates in comparable Organisation for Economic Cooperation and Development (OECD) nations include those for the United States (52), New Zealand (37), Denmark (38), Norway (34), and Sweden (32 per 100 000 population).7. We identified age and sex differences in the incidence of ACL reconstruction surgery, with the peak incidence in males being for a slightly older age group and 73% higher than the peak incidence in females. This is consistent with studies that have reported higher rates of ACL reconstruction in males,2,18,19 despite females being two to ten times more likely to ...
The elements that give stability to the joints are the ligaments. They are arranged in a certain way in the joint to avoid movements that the joint should not perform.. In the case of the knee are 4 ligaments whose only function is to keep it stable: the collateral ligaments and the cruciate ligaments. Here is an image with the graphic representation of the different structures of the knee joint:. On the collateral ligaments, we will not explain too much because they are not the central theme of the article: these are located one on each side of the knee (i.e. an internal collateral ligament and an external collateral ligament).. On the other hand, we will speak in depth of the cruciate ligaments, within the joint capsule of the knee. The cruciate ligaments are 2 structures that are very deep in the knee joint. The cruciate ligaments are 2: one that is located in the anterior part and one that is located in the back.. The posterior cruciate ligament extends between the posterior intercondylar ...
Anterior cruciate ligament (ACL) ruptures are severe sport injuries associated with long absence from sport [ 11 , 20 , 31 ]. The best way to restore