1,454 results match your criteria Medial Collateral Knee Ligament Injury


Orthopedic Injuries in Professional Surfers: A Retrospective Study at a Single Orthopedic Center.

Clin J Sport Med 2020 Jul;30(4):378-382

Kramer Orthopedics, Newport Beach, CA.

Background: Literature regarding surfing injuries is scarce and most studies report a high number of minor injuries. Recent literature suggests that musculoskeletal injuries are more common than previously reported. In the mid 2000s, competitive surfing has seen an increase in aerial maneuvers, as they have become more highly rewarded by the judging panel, which may be contributing to a change in injury patterns. Read More

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http://dx.doi.org/10.1097/JSM.0000000000000596DOI Listing

Risk Factors for Grade 3 Pivot Shift in Knees With Acute Anterior Cruciate Ligament Injuries: A Comprehensive Evaluation of the Importance of Osseous and Soft Tissue Parameters From the SANTI Study Group.

Am J Sports Med 2020 Jul 6:363546520935866. Epub 2020 Jul 6.

Kansas City University of Medicine and Biosciences, Kansas City, Missouri, USA.

Background: Preoperative grade 3 pivot shift has been reported to be associated with higher rates of anterior cruciate ligament (ACL) failure, persistent instability, and inferior patient-reported outcomes. The etiology of a high-grade pivot shift is multifactorial, and numerous factors have been suggested to be responsible. More attention has recently been focused on injury to the anterolateral structures (ALS) as a risk factor for a grade 3 pivot shift. Read More

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http://dx.doi.org/10.1177/0363546520935866DOI Listing

[Erratum to: Osteochondral injury of the femoral insertion of the deep medial collateral ligament of the knee-is there a successful surgical treatment?]

Unfallchirurg 2020 Jun 25. Epub 2020 Jun 25.

Klinik für Orthopädie und Traumatologie, Universitätsspital Insel, Bern, Schweiz.

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http://dx.doi.org/10.1007/s00113-020-00834-2DOI Listing

Radiological Identification of Injury to the Kaplan Fibers of the Iliotibial Band in Association With Anterior Cruciate Ligament Injury.

Am J Sports Med 2020 Jun 24:363546520931854. Epub 2020 Jun 24.

OrthoSport Victoria Research Unit, Richmond, Australia.

Background: Recent biomechanical studies have demonstrated that the Kaplan fibers (KFs) of the iliotibial band play a role in the control of anterolateral rotation of the knee. However, controversy exists regarding whether the KFs are injured in conjunction with anterior cruciate ligament (ACL) injury.

Purpose: To establish the prevalence of radiological injury to the KFs in the ACL-injured knee; to evaluate the effect of the time interval between injury and magnetic resonance imaging (MRI) on diagnosis of KF injury; and to assess for any association between KF injury and other qualitative radiological findings. Read More

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http://dx.doi.org/10.1177/0363546520931854DOI Listing

Multiphasic scaffold for scapholunate interosseous ligament reconstruction: A study in the rabbit knee.

J Orthop Res 2020 Jun 24. Epub 2020 Jun 24.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.

Scapholunate interosseous ligament tears are a common wrist injury in young and active patients that can lead to suboptimal outcomes after repair. This research aims to assess a multiphasic scaffold using 3D-printing for reconstruction of the dorsal scapholunate interosseous ligament. The scaffold was surgically implanted in vivo in the position of the native rabbit medial collateral ligament. Read More

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http://dx.doi.org/10.1002/jor.24785DOI Listing

Deep MCL injury cases with arthroscopic findings of hypermobile medial meniscus: A report of six cases of arthroscopic meniscal suture repair.

Asia Pac J Sports Med Arthrosc Rehabil Technol 2020 Oct 9;22:1-4. Epub 2020 Jun 9.

Department of Sports Orthopedic Surgery, Kanto Rosai Hospital, 1-1 Kizuki Sumiyoshi-cho, Nakahara-ku, Kawasaki city, Kanagawa-pref, Japan.

MRI did not detect any abnormality in the medial meniscus besides high-intensity changes at the meniscofemoral portion of the deep medial collateral ligament. Although pure valgus stress test proved no medial joint widening at 0° and 30°, when an examiner applied knee valgus and tibial external rotation force, the patient experienced pain in the anteromedial knee joint that coincided with their refractory symptoms in individual specific activity. Arthroscopy investigation confirmed that the anterior to middle segment of the medial meniscus had excessively slid into the central direction by a probe-drawing manoeuvre; synchronous meniscal movement in the valgus and external rotation test was also observed. Read More

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http://dx.doi.org/10.1016/j.asmart.2020.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289751PMC
October 2020

[Biomechanical comparison of single-bundle and anatomical double-bundle reconstructions for grade medial collateral ligament injury].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2020 Jun;34(6):720-725

Guangzhou Medical University, Guangzhou Guangdong, 511436, P.R.China;Department of Sports Medicine, Second People's Hospital, Shenzhen Guangdong, 518002, P.R.China.

Objective: To evaluate and compare knee joint stability of grade Ⅲ medial collateral ligament (MCL) injury treated by single-bundle and anatomical double-bundle reconstruction methods, thus providing biomechanical basis for clinical treatment.

Methods: Nine fresh cadaver specimens of normal human knee joints were randomly divided into 3 groups on average. In intact MCL group: The anterior cruciate ligament (ACL) was detached and reconstructed with single-bundle techniques, and the MCL was intact. Read More

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http://dx.doi.org/10.7507/1002-1892.201911057DOI Listing

Analysis of partial bundle anterior cruciate ligament tears- diagnosis and management with ACL augmentation.

J Clin Orthop Trauma 2020 May 29;11(Suppl 3):S337-S341. Epub 2019 Aug 29.

Dept. of Orthopedics, IMS, BHU, Varanasi, India.

Objectives: Partial ACL tears are increasingly recognized in young active patients. They can evolve into complete tears. Controversy exists regarding the need to spare intact ACL bundle as it has its advantages considering biomechanical strength, blood supply and proprioception. Read More

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http://dx.doi.org/10.1016/j.jcot.2019.08.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275279PMC

The risk of concomitant injuries of the contralateral side in valgus injured knee by lateral bumper impact - "Windswept injury mechanism".

Injury 2020 May 6. Epub 2020 May 6.

Department of Orthopaedics Surgery, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea. Electronic address:

Purpose: Valgus injury of high energy of the lateral bumper impact can lead blows to the inside of the knee that push the knee outwards or indirect injury where a varus force is applied to the contralateral knee, which injury pattern named as "Windswept injury mechanism" in this study. The objective of this study was to establish injury pattern in the contralateral side knee on the basis of this pattern recognition to enhance a diagnosis of interrelated osseous and soft-tissue injuries.

Methods: Sixteen patients by "Windswept injury mechanism" were identified, who visited a level 1 trauma center between Jan 2007 and Dec 2016. Read More

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http://dx.doi.org/10.1016/j.injury.2020.03.062DOI Listing

One-Stage Repair of Posterior Oblique Ligament Avulsion Fracture Combined with Medial Collateral Ligament Injury.

Orthop Surg 2020 Jun 9. Epub 2020 Jun 9.

Department of Orthopaedic Surgery, Second Hospital of Shanxi Medical University, Taiyuan, China.

Objective: To evaluate the clinical effect of the one-stage repair of a posterior oblique ligament avulsion fracture combined with a medial collateral ligament injury.

Methods: This study was a retrospective trial. From February 2007 to May 2017, five patients with posterior oblique ligament avulsion fracture combined with medial collateral ligament injury were included in this study. Read More

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http://dx.doi.org/10.1111/os.12697DOI Listing

The medial ligaments and the ACL restrain anteromedial laxity of the knee.

Knee Surg Sports Traumatol Arthrosc 2020 Jun 5. Epub 2020 Jun 5.

Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, SW7 2AZ, UK.

Purpose: The purpose of this study was to determine the contribution of each of the ACL and medial ligament structures in resisting anteromedial rotatory instability (AMRI) loads applied in vitro.

Methods: Twelve knees were tested using a robotic system. It imposed loads simulating clinical laxity tests at 0° to 90° flexion: ±90 N anterior-posterior force, ±8 Nm varus-valgus moment, and ±5 Nm internal-external rotation, and the tibial displacements were measured in the intact knee. Read More

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http://dx.doi.org/10.1007/s00167-020-06084-4DOI Listing

Concomitant Posterolateral Corner Injuries in Skeletally Immature Patients With Acute Anterior Cruciate Ligament Injuries.

J Pediatr Orthop 2020 Jul;40(6):271-276

Departments of Orthopaedic Surgery, Division of Sports Medicine.

Background: Missed posterolateral corner (PLC) injuries are a known cause of anterior cruciate ligament reconstruction (ACL) failure in the adult population. Failed ACL reconstruction causes significant morbidity in the skeletally immature pediatric population. There is little literature on the character and potential significance of PLC injuries in skeletally immature patients. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001450DOI Listing

Incidence of Lower Extremity Injury in the National Football League: 2015 to 2018.

Am J Sports Med 2020 Jun 2:363546520922547. Epub 2020 Jun 2.

Bellin Health Titletown Sports Medicine and Orthopedics, Green Bay, Wisconsin, USA.

Background: Lower extremity injuries are the most common injuries in professional sports and carry a high burden to players and teams in the National Football League (NFL). Injury prevention strategies can be refined by a foundational understanding of the occurrence and effect of these injuries on NFL players.

Purpose: To determine the incidence of specific lower extremity injuries sustained by NFL players across 4 NFL seasons. Read More

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http://dx.doi.org/10.1177/0363546520922547DOI Listing

The anterolateral ligament in acute knee trauma: patterns of injury on MR imaging.

Skeletal Radiol 2020 May 29. Epub 2020 May 29.

Stoke Mandeville Hospital, Buckingahmshire Healthcare NHS Trust, Aylesbury, UK.

Objective: To delineate the spectrum of traumatic knee injuries associated with injury of the anterolateral ligament of the knee (ALL).

Materials And Methods: A retrospective review of 200 MRI scans undertaken for acute knee trauma was performed. In each scan, the ALL was scored as normal, sprained or torn. Read More

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http://dx.doi.org/10.1007/s00256-020-03446-4DOI Listing
May 2020
1.743 Impact Factor

[Osteochondral injury of the femoral insertion of the deep medial collateral ligament of the knee-is there a successful surgical treatment?]

Unfallchirurg 2020 May 29. Epub 2020 May 29.

Klinik für Orthopädie und Traumatologie, Universitätsspital Insel, Freiburgstraße, 3010, Bern, Schweiz.

Isolated ruptures of the deep portion of the medial collateral ligament (MCL) without clinical instability can mostly be treated conservatively with good clinical results. A 10-year-old girl was initially also treated conservatively. As symptoms of pain and limited range of motion were not resolved after 3 months of conservative treatment and although there were no signs of instability, it was decided to proceed with the surgical intervention. Read More

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http://dx.doi.org/10.1007/s00113-020-00829-zDOI Listing

Arthroscopic pie-crusting release of the posteromedial complex of the knee for surgical treatment of medial meniscus injury.

BMC Musculoskelet Disord 2020 May 14;21(1):301. Epub 2020 May 14.

Henan Luoyang Orthopedic-Traumatological Hospital (Henan Orthopedic Hospital), No.80 Qingming southern Road, Luoyang, 471002, China.

Background: An arthroscopic narrow posteromedial gap of the knee may cause failure of a meniscus operation. The posteromedial complex (PMC) of the knee, including the posterior part of the medial collateral ligament (MCL) and the posterior oblique ligament (POL), has a restrictive effect on the opening of the posteromedial gap of the knee in the half-extension position. Thus, we evaluated the radiological and clinical results of pie-crusting release of the PMC for arthroscopic meniscal surgery in tight knees. Read More

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http://dx.doi.org/10.1186/s12891-020-03336-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7227207PMC

Analysis of Risk Factors for Ramp Lesions Associated With Anterior Cruciate Ligament Injury.

Am J Sports Med 2020 Jun 8;48(7):1673-1681. Epub 2020 May 8.

Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea.

Background: The incidence of meniscocapsular junction tears of the medial meniscus posterior horn, known as , is reported to be 9.3% to 23.9%. Read More

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http://dx.doi.org/10.1177/0363546520918207DOI Listing

Percutaneous Superficial Medial Collateral Ligament Release Outcomes During Medial Meniscal Arthroscopy: A Systematic Review.

Arthrosc Sports Med Rehabil 2020 Apr 19;2(2):e153-e159. Epub 2020 Jan 19.

University Hospitals Sports Medicine Institute, Cleveland, Ohio, U.S.A.

Purpose: To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL) lengthening during knee arthroscopy to address isolated medial meniscal pathology.

Methods: A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. The inclusion criteria consisted of English-language articles or articles with English-language translations documenting the use of percutaneous sMCL lengthening during arthroscopic knee surgery to treat isolated meniscal pathology (repair vs meniscectomy) with reported postoperative outcomes and complications. Read More

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http://dx.doi.org/10.1016/j.asmr.2019.10.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190537PMC

Single-bundle MCL reconstruction with anatomic single-bundle ACL reconstruction does not restore knee kinematics.

Knee Surg Sports Traumatol Arthrosc 2020 Apr 27. Epub 2020 Apr 27.

Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, 3471 Fifth Avenue, Suite 1010, Kaufmann Building, Pittsburgh, PA, 15213, USA.

Purpose: The purpose of this study was to evaluate and compare knee kinematics and kinetics following either single bundle, modified triangular or double-bundle reconstruction of the superficial medial collateral ligament (sMCL) with single bundle anatomic ACL reconstruction.

Methods: Using a cadaveric model (n = 10), the knee kinematics and kinetics following three MCL reconstructions (single-bundle (SB), double-bundle (DB), modified triangular) with single bundle anatomic ACL reconstruction were compared with the intact and deficient knee state. The knees were tested under (1) an 89-N anterior tibial load, (2) 5 N-m internal and external rotational tibial torques, and (3) a 7 N-m valgus torque. Read More

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http://dx.doi.org/10.1007/s00167-020-05934-5DOI Listing

Timing of Strain Response of the ACL and MCL Relative to Impulse Delivery During Simulated Landings Leading up to ACL Failure.

J Appl Biomech 2020 Apr 22:1-8. Epub 2020 Apr 22.

Sparta Science.

Anterior cruciate ligament (ACL) injury videos estimate that rupture occurs within 50 milliseconds of initial contact, but are limited by imprecise timing and nondirect data acquisition. The objective of this study was to precisely quantify the timing associated with ligament strain during simulated landing and injury events. The hypotheses tested were that the timing of peak strain following initial contact would differ between ligaments and that peak strain timing would be independent of the injury-risk profile emulated during simulated landing. Read More

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http://dx.doi.org/10.1123/jab.2019-0308DOI Listing
April 2020
0.904 Impact Factor

Management of multiligament knee injuries.

EFORT Open Rev 2020 Mar 2;5(3):145-155. Epub 2020 Mar 2.

Chesterfield Royal Hospital NHS Foundation Trust, Calow, Chesterfield, UK.

Up to 18% of multiligament knee injuries (MLKI) have an associated vascular injury.All MLKI should be assessed using the ankle brachial pressure index (ABPI) with selective arteriography if ABPI is < 0.9. Read More

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http://dx.doi.org/10.1302/2058-5241.5.190012DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144894PMC

The superficial medial collateral ligament is the major restraint to anteromedial instability of the knee.

Knee Surg Sports Traumatol Arthrosc 2020 Apr 10. Epub 2020 Apr 10.

Department of Trauma, Hand and Reconstructive Surgery, Westphalian Wilhelms University Muenster, Muenster, Germany.

Purpose: The purpose of the present study was to determine how the medial structures and ACL contribute to restraining anteromedial instability of the knee.

Methods: Twenty-eight paired, fresh-frozen human cadaveric knees were tested in a six-degree of freedom robotic setup. After sequentially cutting the dMCL, sMCL, POL and ACL in four different cutting orders, the following simulated clinical laxity tests were applied at 0°, 30°, 60° and 90° of knee flexion: 4 Nm external tibial rotation (ER), 4 Nm internal tibial rotation (IR), 8 Nm valgus rotation (VR) and anteromedial rotation (AMR)-combined 89 N anterior tibial translation and 4 Nm ER. Read More

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http://dx.doi.org/10.1007/s00167-020-05947-0DOI Listing
April 2020
2.837 Impact Factor

Treatment of Concomitant ACL and MCL Injuries: Spontaneous Healing of Complete ACL and MCL Tears.

J Knee Surg 2020 Apr 8. Epub 2020 Apr 8.

Department of MPH, Shiraz University of Medical Sciences, Shiraz, Iran.

The mainstay of treatment for anterior cruciate ligament (ACL) tear is considered to be surgery, especially when associated with medial collateral ligament (MCL) tears. We aimed to evaluate our hypothesis that some patients with concomitant ACL and MCL tears may develop spontaneous healing without surgical intervention. This study was conducted during 2013 to 2017. Read More

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http://dx.doi.org/10.1055/s-0040-1708858DOI Listing

Single-Stage Arthroscopic Anterior and Posterior Cruciate Ligament Repairs and Open Medial Collateral Ligament Repair for Acute Knee Dislocation.

Case Rep Orthop 2020 24;2020:7348201. Epub 2020 Feb 24.

Department of Sports Orthopedic Surgery, Kanto Rosai Hospital, 1-1 Kizukisumiyoshicho, Nakahara-ku, Kawasaki City, Kanagawa Prefecture, Japan.

Till date, there are no clear guidelines regarding the treatment of multiple ligament knee injuries. Ligament repair is advantageous as it preserves proprioception and does not involve grafting. Many studies have reported the use of open repair and reconstruction for multiple ligament knee injuries; however, reports on arthroscopic-combined single-stage anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) repairs are scarce. Read More

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http://dx.doi.org/10.1155/2020/7348201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7060436PMC
February 2020

Posterior cruciate ligament lesions are mainly present as combined lesions even in sports injuries.

Knee Surg Sports Traumatol Arthrosc 2020 Mar 10. Epub 2020 Mar 10.

Centre for Sports Orthopedics and Special Joint Surgery, Orthopedic Hospital Markgroeningen, Kurt-Lindemann-Weg 10, 71706, Markgroeningen, Germany.

Purpose: To analyse 1000 consecutive patients, treated with isolated or combined posterior cruciate ligament (PCL) reconstruction in a single centre according to the epidemiological factors and differences in injury patterns depending on the activity during trauma.

Methods: Between 2004 and 2019, one thousand isolated and combined PCL reconstructions were performed. The medical charts and surgical reports of all patients were analysed regarding epidemiological factors. Read More

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http://dx.doi.org/10.1007/s00167-020-05919-4DOI Listing

[Myofascial trigger point: an indicator of acupoint sensitization].

Zhen Ci Yan Jiu 2020 Jan;45(1):57-61

Institute of Acupuncture and Moxibustion, China Academy of Chinese Medical Sciences, Beijing 100700.

Objective: The present study is to investigate the characteristic distribution of primary pain points and referred pain areas in patients with knee-joint pain diseases, therefore revealing the correlation between the myofascial trigger point and acupoint sensitization.

Methods: A total of 483 patients (320 men and 163 women, 36 to 72 years in age) with knee-joint pain recruited from 4 clinical centers were observed from July, 2017 to April, 2019 in the present study. The areas of primary and referred pain in these patients were detected by thumb-pressing and marked on human anatomic atlas. Read More

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http://dx.doi.org/10.13702/j.1000-0607.1906906DOI Listing
January 2020

The Medial Collateral Ligament in Primary Total Knee Arthroplasty: Anatomy, Biomechanics, and Injury.

J Am Acad Orthop Surg 2020 Jun;28(12):e510-e516

From the Department of Orthopaedics and Traumatology, Queen Mary Hospital, Hong Kong, China (Dr. Cheung and Dr. Chan), and the Department of Orthopaedics and Traumatology (Dr. Yan and Dr. Chiu), University of Hong Kong, Hong Kong, China.

Understanding the anatomy and biomechanics of the medial collateral ligament (MCL) is crucial in producing good outcomes after total knee arthroplasty. A solid grasp of the surgical techniques that address the MCL are necessary to ensure good coronal plane ligament balance. Furthermore, intraoperative injury to the MCL in total knee arthroplasty is an uncommon yet serious complication which often goes unrecognized. Read More

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http://dx.doi.org/10.5435/JAAOS-D-19-00355DOI Listing

Autologous platelet-rich plasma therapy for refractory pain after low-grade medial collateral ligament injury.

J Int Med Res 2020 Feb;48(2):300060520903636

Department of Orthopedics, the First People's Hospital of Yancheng, Yancheng, Jiangsu, China.

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http://dx.doi.org/10.1177/0300060520903636DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7111026PMC
February 2020

MULTI-LIGAMENT KNEE RECONSTRUCTION AND NOVEL MENISCUS RADIAL REPAIR TECHNIQUE, WITH RETURN TO OLYMPIC LEVEL SKIING: A CASE REPORT.

Int J Sports Phys Ther 2020 Feb;15(1):139-147

Twin Cities Orthopedics, Edina, MN, USA.

Background And Purpose: Multi-ligament knee injuries (MLKI) can be debilitating and often career ending injuries for athletes. Current literature reports on outcomes following these injuries for return to activities of daily life; however, there is a paucity of evidence evaluating the return to sport following a MLKI. The purpose of this case report is to describe the treatment and outcome following a MLKI and novel meniscus radial repair technique in which the athlete returned to compete in the 2018 Winter Olympic Games 14 months postoperatively. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015028PMC
February 2020

Medial-Sided Injuries in the Multiple Ligament Knee Injury.

J Knee Surg 2020 May 19;33(5):431-439. Epub 2020 Feb 19.

Orthopaedic Clinic, Oslo University Hospital and University of Oslo, Oslo, Norway.

Multiligament knee injuries (MLKI) are complex and challenging to treat. The posteromedial corner (PMC) structures are commonly torn in MLKI. A thorough and systematic evaluation is imperative to avoid a missed diagnosis and for planning treatment. Read More

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http://dx.doi.org/10.1055/s-0039-3402768DOI Listing

A Case of Medial Tibial Crest Friction Syndrome: A Rare Cause of Medial Knee Pain.

Clin J Sport Med 2020 Feb 6. Epub 2020 Feb 6.

Departments of Physical Medicine and Rehabilitation.

Knee pain is among the most common problems in active patients, with common causes of medial knee pain including meniscal injury, osteoarthritis, medial collateral ligament (MCL) injury, and pes anserine bursopathy/distal hamstring tendinopathy. Some cases of medial knee pain are refractory to standard treatment options and may be caused by rare pathology. We present a case of medial knee pain secondary to medial tibial crest friction syndrome (MTCFS) in a 22-year-old male training for a sprint triathlon after rapidly increasing his training program. Read More

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http://dx.doi.org/10.1097/JSM.0000000000000782DOI Listing
February 2020

Comprehensive Case-Based Review of Knee Ligament Injuries.

Instr Course Lect 2019 ;68:513-544

The management of knee ligament injuries continues to evolve, and much debate persists over the timing of surgery, repair versus reconstruction, surgical technique, postoperative rehabilitation, graft selection, and fixation. Surgeons should be aware of updates on the best management strategies of knee ligament injuries in 2018 and understand the important history and physical examination findings of the knee with ligamentous injury; the anterior cruciate ligament; the role of the anterolateral ligament and lateral extra-articular tenodesis; combined anterior cruciate ligament and medial collateral ligament injuries; the posterior cruciate ligament; medial collateral ligament repair versus reconstruction; posterolateral corner repair versus reconstruction; the role of coronal plane osteotomies, including high tibial osteotomy and distal femoral osteotomy; the role of sagittal plane osteotomies, including anterior closing wedge osteotomy and anterior opening wedge osteotomy; the initial management of the multiligament-injured knee; and five keys to avoiding complications in the multiligament-injured knee. The best available evidence and sample case presentations help guide surgical decision making and improve patient outcomes. Read More

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February 2020

Optimizing Anterior Cruciate Ligament (ACL) Outcomes: What Else Needs Fixing Besides the ACL?

Instr Course Lect 2020 ;69:653-660

This review focuses on the management of anterior cruciate ligament (ACL) reconstruction patients when other concomitant pathology may need to be addressed at the time of surgery. Given the role of the posterior horn of the medial meniscus in preventing osteoarthritis progression and contributing to knee stability, medial meniscus repair should always be considered when performing ACL reconstruction. Meniscal transplant may also be appropriate in select patients with normal knee alignment and absent of cartilage abnormalities in the compartment. Read More

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February 2020

Factors associated with revision following anterior cruciate ligament reconstruction: A systematic review of registry data.

Knee 2020 Mar 31;27(2):287-299. Epub 2020 Jan 31.

University of Auckland, Auckland, New Zealand; Department of Orthopaedic Surgery, North Shore Hospital, Auckland, New Zealand.

Background: To identify the patient and surgical factors associated with revision anterior cruciate ligament (ACL) reconstruction as reported by all national and community ACL registries.

Methods: A systematic review was performed on the MEDLINE, Embase and Cochrane Library databases. Eligibility criteria included English studies published by national or community ACL registries reporting on primary ACL reconstruction and risk factors associated with revision ACL reconstruction. Read More

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http://dx.doi.org/10.1016/j.knee.2019.12.003DOI Listing
March 2020
1.702 Impact Factor

Variation in ACL and MCL Strain Before Initial Contact Is Dependent on Injury Risk Level During Simulated Landings.

Orthop J Sports Med 2019 Nov 27;7(11):2325967119884906. Epub 2019 Nov 27.

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.

Background: The existent literature has well explored knee ligament kinetics and strain at and after initial contact (IC) during landing tasks. However, little is known about knee ligament biomechanics in flight before IC.

Purpose: To quantify and compare change in anterior cruciate ligament (ACL) and medial collateral ligament (MCL) strain before IC relative to after IC. Read More

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http://dx.doi.org/10.1177/2325967119884906DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6967202PMC
November 2019

Joint laxity varies in response to partial and complete anterior cruciate ligament injuries throughout skeletal growth.

J Biomech 2020 Mar 16;101:109636. Epub 2020 Jan 16.

Joint Department of Biomedical Engineering, North Carolina State University and the University of North Carolina - Chapel Hill, Raleigh, NC 27695, United States; Comparative Medicine Institute, North Carolina State University, Raleigh, NC 27695, United States; Department of Orthopaedics, University of North Carolina - Chapel Hill, Chapel Hill, NC 27599, United States. Electronic address:

Anterior cruciate ligament (ACL) injuries are increasingly common in the skeletally immature population. As such there is a need to increase our understanding of the biomechanical function of the joint following partial and complete ACL injury during skeletal growth. In this work, we aimed to assess changes in knee kinematics and loading of the remaining soft tissues following both partial and complete ACL injury in a porcine model. Read More

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http://dx.doi.org/10.1016/j.jbiomech.2020.109636DOI Listing

Hoffa fracture associated with tibial shaft fracture and multiple ligament avulsion fractures: A case report.

Trauma Case Rep 2020 Apr 17;26:100277. Epub 2020 Jan 17.

Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, PR China.

Hoffa fracture combined with tibial shaft fracture and multiple ligament avulsion injuries is extremely rare. Herein, we report a case of medial Hoffa fracture with associated fracture of tibial shaft and avulsion fractures of multiple ligaments secondary to knee dislocation. A 17-year-old female with history of a motorcycle accident was referred to our hospital after knee joint reduction at a regional trauma center. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100277DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6970162PMC

Risk factors for passive anterior tibial subluxation on MRI in complete ACL tear.

Orthop Traumatol Surg Res 2020 May 23;106(3):465-468. Epub 2020 Jan 23.

Université Paris Saclay, AP-HP, 92100 Boulogne-Billancourt, France.

Introduction: In anterior cruciate ligament (ACL) tear, passive spontaneous anterior tibial subluxation (ATS), with respect to the femur, is sometimes observed on MRI. In a case-control study, ATS>3.5mm showed 100% specificity (±3. Read More

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http://dx.doi.org/10.1016/j.otsr.2019.10.025DOI Listing

Arthroscopic suture bracing of posterior cruciate ligament in a multiple ligament knee injury - A technical report.

Trauma Case Rep 2020 Feb 15;25:100279. Epub 2020 Jan 15.

Theresienkrankenhaus Mannheim, Dept. Unfallchirurgie und Sporttraumatologie, Bassermannstraße 1, 68165 Mannheim, Germany.

The optimum therapy of a torn PCL in multiligamental-injured knees is controversially discussed in literature. As conservative treatment and PCL reconstruction alone mostly lead to long-term immobilization, we performed a single stage PCL bracing with ACL reconstruction using ACL TightRopes® and Fiber-/TigerTapes® to accelerate back-to-sport after multiligamental knee injury with bicrucial tears. The brace consisted of two FiberTapes which were looped in an ACL TightRope and transosseously fixed with a Dog Bone-Button®. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100279DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6962691PMC
February 2020

Collateral Ligament Knee Injuries in Pediatric and Adolescent Athletes.

J Pediatr Orthop 2020 Feb;40(2):71-77

Boston Childrens Hospital, Harvard Medical School, Boston, MA.

Background: The majority of research on medial (MCL) and lateral (LCL) collateral ligament injuries has focused on adults and combined collateral/cruciate injuries. The purpose of this study was to determine characteristics associated with isolated collateral ligament injuries in adolescents, and assess timing for return to sports.

Methods: Electronic medical records were queried to identify patients aged below 17 years who sustained a magnetic resonance imaging-confirmed isolated MCL or LCL injury over an 8-year period. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001112DOI Listing
February 2020

Ultrastructural Assessment of the Anterolateral Ligament.

Orthop J Sports Med 2019 Dec 18;7(12):2325967119887920. Epub 2019 Dec 18.

Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, University of Rome Sapienza, Rome, Italy.

Background: The anterolateral ligament (ALL) has been identified as a structure on the lateral side of the knee, but debate exists regarding whether it is a capsular thickening or a ligament.

Hypothesis: A detailed ultrastructural characterization of the ALL and its ultrastructure collagen arrangement will reveal it more closely resembles ligamentous tissue than joint capsule.

Study Design: Descriptive laboratory study. Read More

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http://dx.doi.org/10.1177/2325967119887920DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6920591PMC
December 2019

Avulsion fracture of the medial head of the gastrocnemius muscle associated with multiple ligament injuries before closure of the growth plate: a case report.

J Med Case Rep 2019 Dec 25;13(1):382. Epub 2019 Dec 25.

Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima-city, Kagoshima, 890-8520, Japan.

Background: Avulsion fracture of the medial head of the gastrocnemius muscle is a very rare phenomenon. There are no reports of avulsion fractures associated with multiple ligament injuries before closure of the growth plate. The authors present a case of avulsion fracture of the insertion of the medial head of the gastrocnemius muscle associated with posterior cruciate ligament injury and an avulsion fracture of the medial collateral ligament at the femoral attachment. Read More

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http://dx.doi.org/10.1186/s13256-019-2325-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930683PMC
December 2019

[Treatment of degenerative medial meniscus injury of knee joint by arthroscopy combined with small needle knife to release superficial medial collateral ligament of knee joint].

Zhongguo Gu Shang 2019 Dec;32(12):1090-1093

Department of Joint Surgery, Haining Hospital of Traditional Chinese Medicine, Haining 314400, Zhejiang, China.

Objective: To explore the clinical effect of arthroscopic combined with small needle knife in the treatment of degenerative medial meniscus (MM) injury of knee joint by releasing the superficial layer of medial collateral ligament (SMCL).

Methods: From February 2016 to November 2018, 56 patients (56 knees) with limited pain, strangulation and flexion in medial knee joint space were selected. X-ray Kellgren-Lawrence grading was I-II. Read More

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http://dx.doi.org/10.3969/j.issn.1003-0034.2019.12.004DOI Listing
December 2019

Editorial Commentary: Variations of National Health Systems: Time From Injury to Surgery Can Affect Anterior Cruciate Ligament-Medial Collateral Ligament Treatment Outcomes.

Authors:
Mark G Siegel

Arthroscopy 2020 01;36(1):212-213

A recent investigation using the Swedish National Knee Registry large database showed that "The risk of ACL revision did not differ between HT and PT autografts in patients undergoing ACL reconstruction with a non-surgically treated MCL injury. However, the use of ST-G was associated with poorer two-year patient-reported knee function compared with the ST." However, the Swedish Health care system is so unique that the results may not be universally applicable. Read More

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http://dx.doi.org/10.1016/j.arthro.2019.10.003DOI Listing
January 2020

Avulsion of the femoral attachment of the medial collateral ligament in the setting of knee multiligament injury: A case report.

Medicine (Baltimore) 2019 Dec;98(50):e18376

Orthopaedic Medical Center, The Second Hospital of Jilin University, Changchun, China.

Rationale: Medial collateral ligament (MCL) injury is a common sports injury. The damage mainly occurs in ligament fibers, but MCL avulsion fracture is extremely rare and only a few reports have been published.

Patient Concerns: Herein, we present a healthy 21-year-old man with an avulsion fracture of the MCL of the right knee sustained during snowboarding. Read More

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http://dx.doi.org/10.1097/MD.0000000000018376DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6922482PMC
December 2019

Irreducible Knee Dislocation Associated With a Tertiary Gastrocnemius Head: A Case Report.

JBJS Case Connect 2019 Dec;9(4):e0476

Department of Orthopaedics & Rehabilitation, The University of New Mexico Health Sciences Center, Albuquerque, New Mexico.

Case: A 43-year-old man suffered an irreducible posterolateral knee dislocation while snowboarding with associated tears of the anterior cruciate, posterior cruciate, medial collateral, and posterolateral corner ligaments. Two closed reduction attempts failed, and magnetic resonance imaging revealed incarcerated soft tissue from a tertiary gastrocnemius muscle head. The patient underwent open reduction and repair/reconstruction of his multiligamentous knee injury. Read More

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http://dx.doi.org/10.2106/JBJS.CC.18.00476DOI Listing
December 2019

Tears in the distal superficial medial collateral ligament: the wave sign and other associated MRI findings.

Skeletal Radiol 2020 May 9;49(5):747-756. Epub 2019 Dec 9.

Radiology and Imaging Sciences, CC-NIH, 10 Center Drive, Bethesda, MD, 20892, USA.

Objective: To analyze the MRI characteristics of distal superficial medial collateral ligament (sMCL) tears and to identify features of tears displaced superficial to the pes anserinus (Stener-like lesion (SLL)).

Materials And Methods: Knee MRI examinations at four institutions were selected which showed tears of the sMCL located distal to the joint line. MRIs were evaluated for a SLL, a wavy contour to the sMCL, and the location of the proximal sMCL stump. Read More

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http://dx.doi.org/10.1007/s00256-019-03352-4DOI Listing

Associated Morbidity After the Percutaneous Release of the Medial Collateral Ligament for Knee Arthroscopy.

Arthroscopy 2020 03 29;36(3):891-900. Epub 2019 Nov 29.

Department of Orthopaedic Surgery, University of Virginia, Charlottesville, Virginia, U.S.A. Electronic address:

Purpose: To summarize available data on the morbidity associated with percutaneous release of the medial collateral ligament (MCL) of the knee during arthroscopy via a "pie-crusting" technique.

Methods: A search of the literature was performed using the MEDLINE and Web of Science databases to identify studies examining the morbidity of percutaneous MCL release during arthroscopy. Only English-language articles were included; technical articles and studies not focused on the use of this technique were omitted. Read More

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http://dx.doi.org/10.1016/j.arthro.2019.08.051DOI Listing

The Irreducible Knee Dislocation.

J Knee Surg 2020 Apr 22;33(4):328-334. Epub 2019 Nov 22.

Pan Am Clinic, University of Manitoba, Winnipeg, Manitoba, Cananda.

Irreducible knee dislocations are a small subset of acute knee dislocations and are extremely rare. The most common type of irreducible knee dislocation is posterolateral, which can be challenging to diagnose both clinically and on plain radiographs. Vascular injury is uncommon and closed reduction is seldom possible due to medial femoral condyle buttonholing through soft tissues requiring open or arthroscopic reduction. Read More

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http://dx.doi.org/10.1055/s-0039-1698749DOI Listing

Effects of hyperbaric oxygen therapy on recovery acceleration in Japanese professional or semi-professional rugby players with grade 2 medial collateral ligament injury of the knee: A comparative non-randomized study.

Undersea Hyperb Med 2019 Sep - Dec - Fourth Quarter;46(5):647-654

Department of Orthopaedic Surgery, Tokyo Medical and Dental University.

Introduction: The effects of hyperbaric oxygen (HBO2) therapy on sprains, ligament injuries, and muscle strains have been reported in several animal studies. In a dog model of compartment syndrome and in a rat contused skeletal muscle injury model, the significant effects of HBO2 therapy on the reduction of edema and muscle necrosis have been reported. In basic research HBO2 therapy stimulated fibroblast activity to improve the healing process. Read More

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November 2019
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