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Mil Med 2019 Apr 20. Epub 2019 Apr 20.

Mont-Louis Private Hospital, 8 rue de la Folie-Regnault 75011 Paris, France.

Missile injuries of the sciatic nerve are frequently encountered in modern violent conflicts. Gunshot and fragment wounds may cause large nerve defects, for which management is challenging. The great size of the sciatic nerve, in both diameter and length, explains the poor results of nerve repair using autografts or allografts. Read More

Malays Orthop J 2019 Mar;13(1):25-29

Department of Surgery, International Islamic University of Malaysia, Kuantan, Malaysia.

Large wounds in the leg require combination of local flaps or free flap for wound coverage. Gastrocnemius musculocutaneous flap (GMCF) allows a large wound to be covered by a single local flap. However, the conventional GMCF is often associated with donor site morbidity where the exposed soleus raphe causes poor uptake of the skin graft. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2019 Apr;33(4):467-470

Department of Hand and Microsurgery, Xiangya Hospital, Central South University, Changsha Hunan, 410008, P.R.China.

Objective: To investigate the feasibility and effectiveness of the superior lateral genicular artery perforator flap for repairing of soft tissue defects in extremities.

Methods: Between September 2010 and October 2017, 11 cases of skin and soft tissue in extremities were repaired with the superior lateral genicular artery perforator flap. There were 10 males and 1 female, with an average age of 37. Read More

Ann Transl Med 2019 Feb;7(4):70

Department of Orthopaedic Surgery, Lenox Hill Hospital, New York, NY, USA.

Soft tissue dysfunction can result from the degeneration of tissues as in the case of degenerative tendinopathy or from the build-up of problematic scar tissue, which can be the result of several aggravating factors, including overuse injuries, acute or chronic trauma, or as a result of surgery. This dysfunction often results in impaired movement, pain, and swelling of the affected area, which can lead to patient dissatisfaction and a lower quality of life. These soft tissue dysfunctions also have a marked economic impact. Read More

Bone Joint J 2019 Apr;101-B(4):435-442

Department of Orthopaedic Surgery, Azienda Ospedaliero Universitaria di Modena, University of Modena and Reggio-Emilia, Modena, Italy.

Aims: The purpose of this multicentre observational study was to investigate the association between intraoperative component positioning and soft-tissue balancing on short-term clinical outcomes in patients undergoing robotic-arm assisted unicompartmental knee arthroplasty (UKA).

Patients And Methods: Between 2013 and 2016, 363 patients (395 knees) underwent robotic-arm assisted UKAs at two centres. Pre- and postoperatively, patients were administered Knee Injury and Osteoarthritis Score (KOOS) and Forgotten Joint Score-12 (FJS-12). Read More

Gait Posture 2019 May 11;70:298-304. Epub 2019 Mar 11.

Institute of Science and Technology in Medicine, Keele University, ST5 5BG, UK; ORLAU, RJAH Orthopaedic Hospital, Oswestry, Shropshire, SY10 7AG, UK. Electronic address:

Background: "Dynamic knee valgus" has been identified as a risk factor for significant knee injuries, however, the limits and sources of error associated with existing 3D motion analysis methods have not been well established.

Research Question: What effect does the use of differing static and functional knee axis orientation methods have on the observed knee angle outputs for the activities of gait, overhead squatting and a hurdle step?

Methods: A pre-existing dataset collected from one season (September 2015-May 2016) as part of a prospective observational longitudinal study was used. A secondary analysis of data for 24 male footballers, from a single British University football team, was conducted in order to evaluate the effect of static (conventional gait model) and dynamic (constrained and unconstrained mDynaKAD) methods on knee joint kinematics for flexion-extension and valgus-varus angles. Read More

J Knee Surg 2019 Mar 28. Epub 2019 Mar 28.

Department of Orthopaedics, Geisinger Medical Center, Danville, Pennsylvania.

With the increasing number of total knee arthroplasties (TKAs) being performed, the incidence of periprosthetic fractures adjacent to a TKA is rising. Minimally invasive plate osteosynthesis (MIPO) has proven to be successful for the biological fixation of many fractures. Advances in surgical instrumentation and techniques made MIPO possible for more complex fractures. Read More

Knee 2019 Mar 19. Epub 2019 Mar 19.

OrthoVirginia, St. Francis Medical Center, Bon Secours, 13710 St. Francis Blvd, Midlothian, VA 23114, United States of America.

Background: Intraoperative complications due to utilization of robotic assistance during unicompartmental knee arthroplasty have not been reported. While inadvertent soft tissue injury has been reported during total knee and hip arthroplasty with autonomous style robotic systems, the incidence of these problems with semiautonomous (i.e. Read More

J Arthroplasty 2019 Feb 27. Epub 2019 Feb 27.

Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH.

Background: Patellar or quadriceps tendon ruptures after total knee arthroplasty constitute a devastating complication with historically poor outcomes. With advances in soft tissue reconstruction and repair techniques, treatment has become more nuanced. Numerous graft options for reconstruction and suture techniques for repair have been described but there is no consensus regarding optimal treatment. Read More

SICOT J 2019 25;5. Epub 2019 Mar 25.

St. George's, University of London, Cranmer Terrace, London SW17 0RE, UK.

Introduction: With external fixation of the femur and tibia, iatrogenic injury to neurovasculature from self-drilling tips of fixation pins is an important consideration in pin placement. Precise knowledge of the neurovascular anatomy in the distal femur and proximal tibia is important to limit potential pin misplacement.

Method: Six pin placement sites on six cadaveric legs were used in accordance with current placement techniques. Read More

Traffic Inj Prev 2019 22;20(2):196-203. Epub 2019 Mar 22.

a Univ Lyon, Université Lyon 1, IFSTTAR, UMRESTTE UMR_T 9405 , Lyon , France.

Objective: This study assesses the effectiveness of protective clothing (motorcycle jacket, trousers, gloves, knee-high or ankle boots, back protection) for motorized 2-wheeler (MTW) riders.

Methods: This retrospective observational study used injury data from the Rhône Registry of Road Accident Victims, plus a postal survey conducted in 2016. Seven thousand one hundred forty-eight MTW riders involved in accidents between 2010 and 2014 were identified from the Registry and were invited to complete a questionnaire. Read More

Clin Orthop Relat Res 2019 Apr;477(4):789-801

J. L. Petfield, C. K. Murray, D. J. Stinner, San Antonio Military Medical Center, JBSA Fort Sam Houston, TX, USA J. L. Petfield, Landstuhl Regional Medical Center, Landstuhl, Germany D. R. Tribble, A. C. Weintrob, Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA B. K. Potter, L R. Lewandowski, Department of Surgery, Uniformed Services University of the Health Sciences-Walter Reed National Military Medical Center, Bethesda, MD, USA A. C. Weintrob, The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc, Bethesda, MD, USA; and Walter Reed National Military Medical Center, Bethesda, MD, USA M. Krauss, Westat, Rockville, MD, USA.

Background: During recent wars, 26% of combat casualties experienced open fractures and these injuries frequently are complicated by infections, including osteomyelitis. Risk factors for the development of osteomyelitis with combat-related open tibia fractures have been examined, but less information is known about recurrence of this infection, which may result in additional hospitalizations and surgical procedures.

Questions/purposes: (1) What is the risk of osteomyelitis recurrence after wartime open tibia fractures and how does the microbiology compare with initial infections? (2) What factors are associated with osteomyelitis recurrence among patients with open tibia fractures? (3) What clinical characteristics and management approaches are associated with definite/probable osteomyelitis as opposed to possible osteomyelitis and what was the microbiology of these infections?

Methods: A survey of US military personnel injured during deployment between March 2003 and December 2009 identified 215 patients with open tibia fractures, of whom 130 patients developed osteomyelitis and were examined in a retrospective analysis. Read More

Arthrosc Tech 2019 Feb 21;8(2):e153-e161. Epub 2019 Jan 21.

Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Injuries of the posterolateral corner (PLC) of the knee lead to chronic lateral and external rotational instability. Successful treatment of PLC injuries requires an understanding of the complex anatomy and biomechanics of the PLC. Several open PLC reconstruction techniques have been published. Read More

J Orthop Surg Res 2019 Mar 21;14(1):85. Epub 2019 Mar 21.

Sports Medicine Department, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

Objective: We compared autografts and allograft using partial and complete transphyseal anterior cruciate ligament (ACL) reconstruction techniques among skeletally immature individuals.

Methods: Male and females younger than 18 and 16 years old, respectively, diagnosed with ACL tear from April 2006 to March 2012 entered the study. One group had four-strand hamstring autograft, and the other had tibialis posterior allograft reconstruction. Read More

Clin Sports Med 2019 Apr 30;38(2):297-304. Epub 2019 Jan 30.

Mayo Clinic, 201 West Center Street, Rochester, MN 55902, USA.

The multiple ligament-injured knee is a complex injury requiring a comprehensive and thorough evaluation prior to tailoring an appropriate treatment plan. Surgical repair and reconstruction of the involved ligaments are frequently discussed in the literature; however, osteotomy to correct limb malalignment may be just as important to obtaining a good outcome. Limb realignment must be carefully evaluated and treated. Read More

Clin Sports Med 2019 Apr;38(2):285-295

Department of Orthopedic Surgery, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA; Department of Sports Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

Several reconstructive techniques exist to treat posterior cruciate ligament (PCL) deficiency. The purpose of this study is to report knee function and clinical stability after PCL reconstruction (PCLR) using an all-inside technique. Thirty-two patients with isolated or combined PCL injuries treated with all-inside PCLR using soft tissue allograft were included. Read More

Clin Sports Med 2019 Apr 19;38(2):247-260. Epub 2019 Jan 19.

Department of Orthopaedic Surgery, University of New Mexico, MSC10 5600, 1 University of New Mexico, Albuquerque, NM 87131-0001, USA. Electronic address:

"KDIV ligamentous injuries of the knee are frequently high-energy injuries with significant soft tissue disruption, gross knee instability, and rarely are treated nonoperatively. KDIVs frequently require external fixation, but when presenting in an isolated fashion can be reconstructed in one setting. Five presentations of KDIV injury are described: closed with multitrauma/closed head injury requiring external fixation, irreducible KDIV requiring semi-emergent open reduction and repair, isolated KDIV without arterial injury undergoing 4-ligament reconstruction after regaining motion, KDIV with varus and slight thrust undergoing medial opening osteotomy before ligament reconstruction, and KDIV with failed ligaments requiring revision and posterior tibial tendon transfer. Read More

Arthroscopy 2019 Apr 11;35(4):1130-1137. Epub 2019 Mar 11.

Division of Sportstrauma, Department of Orthopedics, Aarhus University Hospital, Aarhus, Denmark.

Purpose: The aim of the present randomized controlled trial was to compare 2 different medial patellofemoral ligament reconstruction (MPFL-R) techniques that utilize different femoral fixation principles, which could affect subjective clinical outcomes and surgical morbidity.

Methods: Sixty patients were randomly assigned to 2 MPFL-R techniques: bone or soft-tissue fixation of the graft at the femoral condyle. Patients had operations performed between 2010 and 2015 at a single center. Read More

Acta Chir Orthop Traumatol Cech 2019 ;86(1):51-57

Ortopedická klinika Fakultní nemocnice a Lékařské fakulty Univerzity Karlovy, Hradec Králové.

PURPOSE OF THE STUDY The aim of this study was to evaluate the mid-term outcomes of the surgical reconstruction of Charcot Foot Neuroarthropathy in diabetic patients with failed conservative treatment and indicated for a below-knee amputation. MATERIAL AND METHODS In the period from 2010 to 2015 the surgical reconstruction of inactive, chronic Charcot Foot Neuroarthropathy classified as type II and III by Sanders and Frykbeg was performed in 16 patients with failed conservative treatment. All these patients were by the diabetes centres initially indicated for a below-knee amputation. Read More

Radiol Med 2019 Mar 4. Epub 2019 Mar 4.

Rheumatological Clinic, Università Politecnica delle Marche, Ospedale ''C. Urbani'', Via Aldo Moro, 25, 60035, Jesi, Ancona, Italy.

Osteoarthritis (OA) is the most common disorder of human joints. Imaging is necessary in daily practice for OA patients, and conventional radiography remains the gold standard. However, conventional radiography is not sensitive in the early stage of OA and cannot clearly detect inflammatory condition. Read More

Cureus 2018 Dec 14;10(12):e3730. Epub 2018 Dec 14.

Orthopaedics, Saint James's Hospital, Dublin, IRL.

Acute traumatic patellar dislocations are encountered with relative frequency, making up 3% of all knee injuries. Typically witnessed in younger patients following sporting injuries, this injury can be debilitating, potentially leading to recurrent dislocation, pain, reduction in activity and patellofemoral osteoarthritis. Management of this injury remains controversial, and as such detailed magnetic resonance imaging (MRI) is increasingly recommended to help illustrate the exact nature of osteochondral and soft tissue injury, with a view to assessing the anatomical sequelae of patellar dislocation as well as the potential of recurrence and dictating the need for either conservative or surgical management in the acute setting. Read More

SAGE Open Med Case Rep 2019 22;7:2050313X18823438. Epub 2019 Jan 22.

Division of Plastic and Reconstructive Surgery, McGill University Health Center, Montreal, QC, Canada.

The management of a mangled limb is a challenging endeavor. With the advancement in microsurgery, spare parts surgery (fillet flaps) has gained recent interest. In the context of lower extremity amputation secondary to trauma, viable spare parts can provide stump soft tissue coverage, potentially preserving critical length and obviating above-knee amputations. Read More

Knee Surg Sports Traumatol Arthrosc 2019 Feb 5. Epub 2019 Feb 5.

Escoles Universitaries Gimbernat I Tomàs Cerdà, Sant Cugat del Vallès, Barcelona, Spain.

Purpose: Muscle injuries are common in professional football, even though prevention protocols are being implemented. Genetics constitutes a novel field for studying intrinsic injury risks and performance. Since previous studies involving single nucleotide polymorphisms (SNPs) have shown that SNPs influence muscle injury rate, injury severity and recovery time, the aim was to study the association the SNP of ACTN3 has with those parameters in professional football players. Read More

J Athl Train 2018 Nov;53(11):1037-1048

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of girls' and women's basketball injury data.

Objective: To describe the epidemiology of injuries sustained in high school girls' basketball in the 2005-2006 through 2013-2014 academic years and collegiate women's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study. Read More

J Athl Train 2018 Nov;53(11):1025-1036

Injury Prevention Research Center, University of North Carolina at Chapel Hill.

Context: The advent of Web-based sports injury surveillance via programs such as the High School Reporting Information Online system and the National Collegiate Athletic Association Injury Surveillance Program has aided the acquisition of boys' and men's basketball injury data.

Objective: To describe the epidemiology of injuries sustained in high school boys' basketball in the 2005-2006 through 2013-2014 academic years and collegiate men's basketball in the 2004-2005 through 2013-2014 academic years using Web-based sports injury surveillance.

Design: Descriptive epidemiology study. Read More

J Orthop Trauma 2019 Jan 22. Epub 2019 Jan 22.

Department of Surgery, Uniformed Services University, Bethesda, MD.

Objectives: To determine if there is a patient-reported functional difference between combat-related knee disarticulations (KD) and transfemoral amputations (TFA).

Setting: Role 3 Military Trauma Centers PATIENTS:: We identified and contacted all KDs and TFAs performed at Walter Reed National Military Medical Center, Walter Reed Army Medical Center, and National Naval Medical Center from January 2003 until July 2012 to participate in a retrospective functional cohort analysis. Ten KD patients were available for study completion and were matched against 18 patients in the TFA group. Read More

J Man Manip Ther 2019 Feb 1;27(1):15-23. Epub 2018 Aug 1.

Physical Therapy Program, Department of Exercise Science, University of South Carolina, Columbia, United States of America.

: Tight hamstrings contribute to inefficiency of movement and increased risk for injury. Static stretching is the most common intervention for this problem, but the use of alternatives like instrument-assisted soft tissue mobilization (IASTM) and proprioceptive neuromuscular facilitation (PNF) is increasing among clinicians. This study examined two prospective studies with the common aim of demonstrating the effectiveness of IASTM or PNF over static stretching for improving hamstring tightness. Read More

Oper Orthop Traumatol 2019 Feb 25;31(1):45-55. Epub 2019 Jan 25.

Abteilung für Sportorthopädie, Klinikum rechts der Isar, Ismaninger Str. 22, 81675, München, Deutschland.

Objective: To report a surgical technique for the treatment of patellar tendon ruptures augmented with an internal brace suture tape.

Indications: Acute patellar tendon ruptures, fractures of the distal patellar pole, chronic insufficiency of the patellar tendon or revision surgery for failed repairs.

Contraindications: Severe damage to the surrounding soft tissue. Read More

Zhonghua Shao Shang Za Zhi 2019 Jan;35(1):65-68

Department of Orthopaedics, Tianjin Hospital, Ningqiang County, Hanzhong City, Hanzhong 724400, China.

To investigate the clinical effects of perforating branch flaps of medial vastus muscle in repairing secondary wounds in donor sites of free anterolateral femoral perforator flaps. From August 2014 to December 2016, 12 patients (8 males and 4 females, aged 35-72 years) with skin and soft tissue defects of extremities associated with tendon and bone exposure were treated in Hanzhong Central Hospital. The sizes of the primary wounds after debridement were 10 cm×8 cm-22 cm×14 cm, and the wounds were repaired with 12 cm×10 cm-24 cm×16 cm free anterolateral femoral perforator flaps. Read More

Biomed Rep 2019 Feb 31;10(2):133-139. Epub 2018 Dec 31.

Vinai Parkpian Orthopaedic Research Center, Department of Orthopaedics.

Anterior cruciate ligament (ACL) rupture is one the most common musculoskeletal soft tissue injuries of the knee. Although the exact mechanisms of this injury remain uncertain, genetic variants have been considered to be an intrinsic risk factor associated with ACL rupture. Therefore, the aim of the present study was to determine whether the adiponectin +276G/T polymorphism is associated with susceptibility to ACL rupture in a Thai population. Read More

Chin J Integr Med 2019 Jan 18. Epub 2019 Jan 18.

School of Chinese Medicine, The University of Hong Kong, Hong Kong SAR, China.

Objective: To investigate the immediate analgesic effect of sinew acupuncture for patients with soft-tissue injuries (STIs).

Methods: Two hundreds eligible adult patients suffering from STIs were recruited and received sinew acupuncture with flexible treatment schedules. The number of treatment sessions was pragmatically decided by each patient on the basis of their pain relief. Read More

J Burn Care Res 2019 Feb;40(2):255-258

Department of Plastic Surgery, Faculty of Medicine, Qena University Hospital, South Valley University, Egypt.

Flexion contracture affecting the knee joint is considered a challenging obstacle which usually affects patients' quality of life with significant functional disability. Several surgical procedures have been described for proper closure of surgical defects following contracture release over popliteal fossa. Although keystone flap reported for closure of full thickness burns defects, to the best of our knowledge, it has never been used previously in management of hypertrophic scar contracture around the knee joint. Read More

Pediatr Emerg Care 2019 Jan 7. Epub 2019 Jan 7.

From the Division of Surgery of the Child and the Adolescent, Department Woman-Mother-Child, Lausanne University Hospital, Lausanne, Switzerland.

Background: Differential diagnosis of soft tissue swelling on exposed body parts in the young athlete is large and mostly includes benign self-limiting conditions, once underlying lesion to the bone, the cartilage, and the ligaments is excluded. Morel-Lavallée lesion represents a rare soft tissue injury requiring prompt intervention to ensure favorable outcome.

Cases: A 10-year-old boy presented with 2-week-old swelling of the medial side of the knee without recent traumatic event. Read More

J Am Acad Orthop Surg 2019 Jan 7. Epub 2019 Jan 7.

From the Adult Reconstruction and Joint Replacement Service (Dr. Sculco), the Department of Orthopaedic Surgery (Dr. Kahlenberg), and Limb Lengthening and Complex Reconstruction Service (Dr. Fragomen and Dr. Rozbruch), Hospital for Special Surgery, New York, NY.

Extra-articular deformities of the femur and tibia in conjunction with advanced knee osteoarthritis pose unique challenges for the arthroplasty surgeon. Careful preoperative planning is needed to evaluate both the intra- and extra-articular deformities and to determine the best route to total knee arthroplasty. An intra-articular compensatory correction can typically be performed if the extra-articular deformity is distant from the joint or if preoperative templating shows that bony cuts do not interfere with ligamentous attachments. Read More

BMC Musculoskelet Disord 2019 Jan 5;20(1). Epub 2019 Jan 5.

Tactical Research Unit, Bond University, Robina, Australia.

Background: Musculoskeletal injuries are a problem in military personnel as they detract from force readiness and may prevent deployment. Injuries occur during basic training at three times the rate observed in post-training military service and more commonly in part time (PT) when compared to full time (FT) army personnel. The purpose of this study was to examine differences in rates and patterns of reported injuries between full time (FT) and part time (PT) personnel undertaking army basic training. Read More

Musculoskeletal Care 2019 03 4;17(1):113-119. Epub 2019 Jan 4.

Leidos, San Diego, California, USA.

Purpose: The aims of the present study were: (a) to identify the incidence of osteoarthritis (OA) after a traumatic knee injury; (b) identify the risk of post-traumatic osteoarthritis (PTOA) based on the type of injury; and (c) identify the time from injury to OA diagnosis.

Patients And Methods: The Expeditionary Medical Encounter Database, containing healthcare utilization for all deployment injuries sustained by military service members, was queried for traumatic knee injuries between 2001 and 2016. Subsequent diagnosis of knee OA was identified, defined as PTOA. Read More

Zhongguo Gu Shang 2018 Dec;31(12):1144-1147

Department of Orthopaedics, Yuhang District Traditional Chinese Hospital of Hangzhou, Hangzhou 311106, Zhejiang, China.

Objective: To study the operative methods and clinical effects of stage therapy for the treatment of fractures of tibia plateau with osteofascial compartment syndrome according to its clinical characteristics.

Methods: From April 2014 to May 2017, 22 patients with fractures of tibia plateau with osteofascial compartment syndrome were treated by stage therapy, including 16 males and 6 females, ranging in age from 22 to 56 years old, with an average of 39 years old. Fifteen patients had injuries on the left and 7 patients had injuries on the right. Read More

Zhongguo Gu Shang 2018 Dec;31(12):1140-1143

People's Hospital of Henan Provice, Zhengzhou 450003, Henan, China;

Objective: To explore the clinical curative effect of soft tissue wire rivet for the treatment of fracture of patella cartilage.

Methods: A retrospective study was conducted in 25 patients(25 knees) from June 2015 to February 2017 in patients with patellar cartilage fractures. Among them, 19 were male, 6 were female, 11 were left knee, 14 were right knee. Read More

Int J Environ Res Public Health 2018 12 20;16(1). Epub 2018 Dec 20.

Tactical Research Unit, Bond University, Robina 4226, QLD, Australia.

Despite having to perform the same occupational tasks as full-time soldiers, part-time soldiers may have lower levels of physical conditioning and report higher rates of injury per unit exposure to active service. The purpose of this study was to profile the leading body site of injury occurring in part-time soldiers to inform injury prevention strategies. Injury data from the Australian Army Reserve (ARES) spanning a two-year period were obtained from the Department of Defence Workplace Health, Safety, Compensation and Reporting database pertaining to locations, nature, mechanisms, and the activity being performed at the time of injury. Read More

Oper Orthop Traumatol 2019 Feb 18;31(1):3-11. Epub 2018 Dec 18.

Abteilung für Sportorthopädie, Klinikum rechts der Isar, TU München, Ismaninger Str. 22, 81675, München, Deutschland.

Objective: Anatomical reduction of bony avulsions of the posterior cruciate ligament (PCL) by a suture-bridge™ (Arthrex, Naples, FL, USA) technique to restore posterior knee stability.

Indications: Acute bony tibial avulsions of the PCL and multifragmentary fractures.

Contraindications: Chronic condition of avulsion fractures or posterior instability, advanced knee osteoarthritis, high-grade soft tissue injury, infection. Read More

Tech Orthop 2018 Dec 25;33(4):219-224. Epub 2017 Dec 25.

Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA.

The heterogeneity of available cadaveric, histologic, and radiographic results related to the anterolateral ligament (ALL) does not support its existence as a discrete anatomic structure. Moreover, focusing narrowly on the ALL in isolation, what has previously been referred to as "ALL myopia," obscures a thorough appreciation for the stability contributions of both capsular and extracapsular structures. We consider injury to the soft tissues of the anterolateral knee-the anterolateral complex-just one component of what is frequently found to be a spectrum of pathology observed in the rotationally unstable, anterior cruciate ligament (ACL)-deficient knee. Read More

Indian J Orthop 2018 Nov-Dec;52(6):631-637

Orthopaedic Department, V. S. General Hospital, Ahmedabad, Gujarat, India.

Background: Floating knee is a condition resulting from high energy trauma usually associated with minor to life threatening injuries making it challanging to treat There are no studies available in literature describing cross leg sitting and squatting after surgical management of floating knee. This study analyzes prognostic factors, plan of management, functional outcomes (special attention to squatting and cross legged sitting), complications.

Materials And Methods: 52 patients with floating knee injuries treated over a period of 3 years were included in this study. Read More

Curr Opin Pediatr 2019 Feb;31(1):103-111

Hospital for Special Surgery, New York, New York, USA.

Purpose Of Review: The purpose of this review is to summarize and clarify the current framework for treating tibial spine avulsion fractures (TSAFs). We will discuss how these fractures are classified both on plain radiographs and MRI as well as report the incidence of concomitant soft tissue injury, an important consideration that guides treatment. We will also compare guidelines for nonsurgical versus surgical treatment and summarize frequently used surgical techniques. Read More

J Sci Med Sport 2019 Apr 17;22(4):408-412. Epub 2018 Oct 17.

Faculty of Physical Education, Gdansk University of Physical Education and Sport, Poland.

Objectives: To investigate the role of inter-individual variations in a particular glycoprotein, TNC, and its potential contribution to anterior cruciate ligament (ACL) injury susceptibility in Polish Caucasian participants. ACL rupture is one of the most prevalent and severe knee injury that predominantly occurs during sports participation, primarily via a non-contact mechanism. Several polymorphisms in genes encoding glycoproteins either independently or as allelic combinations, modulate the risk of musculoskeletal soft tissue injuries. Read More

J Biomech 2019 Jan 16;83:9-15. Epub 2018 Nov 16.

Faculty of Health Sciences, University of Ottawa, Canada; Department of Biomedical Sciences, University of Copenhagen, Denmark. Electronic address:

Background: OpenSim models are typically based on cadaver findings that are generalized to represent a wide range of populations, which curbs their validity. Patient-specific modelling through incorporating magnetic resonance imaging (MRI) improves the model's biofidelity with respect to joint alignment and articulations, muscle wrapping, and ligament insertions. The purpose of this study was to determine if the inclusion of an MRI-based knee model would elicit differences in lower limb kinematics and resulting knee ligament lengths during a side cut task. Read More

Am J Sports Med 2019 Jan 19;47(1):138-143. Epub 2018 Nov 19.

Department of Orthopaedic Surgery, Washington University in Saint Louis/Barnes-Jewish Hospital, St Louis, Missouri, USA.

Background:: Ankle sprains are the most common musculoskeletal injury in the United States. Chronic lateral ankle instability can ultimately require operative intervention to decrease pain and restore stability to the ankle joint. There are no anatomic studies investigating the vascular supply to the lateral ankle ligamentous complex. Read More

J Athl Train 2018 Nov 19;53(11):1049-1055. Epub 2018 Nov 19.

Michigan State University, East Lansing.

Context: The sex-based differences in the structure and rules of boys' and girls' lacrosse result in very different styles of play, which may have significant implications for the rates and patterns of injuries.

Objective: To compare the epidemiology of injuries sustained by boys' and girls' lacrosse players.

Design: Descriptive epidemiology study. Read More

J Biomech 2019 Jan 25;82:124-133. Epub 2018 Oct 25.

Department of Mechanical Engineering, University of Wisconsin-Madison, USA. Electronic address:

Injuries to the anterior cruciate ligament (ACL) and menisci commonly lead to early onset osteoarthritis. Treatments that can restore normative cartilage loading patterns may mitigate the risk of osteoarthritis, though it is unclear whether such a goal is achievable through conservative rehabilitation. We used musculoskeletal simulation to predict cartilage and ligament loading patterns during walking in intact, ACL deficient, menisci deficient, and ACL-menisci deficient knees. Read More

Knee 2018 Dec 8;25(6):1129-1133. Epub 2018 Nov 8.

Department of Orthopaedic Surgery, Hospital Clinico Mutual de Seguridad, Santiago, Chile.

Background: Several reports of severe infections associated with allograft tissue in knee reconstructive surgery have led many surgeons to consider routine intraoperative culture of allograft tissue before implantation. Thus, the purpose of this study was to determine the prevalence of positive soft tissue allograft cultures in reconstructive knee surgery, and evaluate its association with surgical site infection.

Methods: Retrospective study of 202 patients who underwent knee reconstructive ligament surgeries, including revisions, between January 2013 and July 2017. Read More

Sports Med Arthrosc Rev 2018 Dec;26(4):150-152

GHS Orthopaedics and Sports Medicine, Danville, PA.

The purpose of this paper is to present an overview of the progress in treatment of knee dislocations and posterior cruciate ligament (PCL)-based multiple ligament knee injuries over the past 25 years. The perspectives of where we were 25 years ago, where we are today, and where we will be in the future will be explored. Read More