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Cureus 2022 May 13;14(5):e24965. Epub 2022 May 13.

Orthopedic Surgery, Lake Erie College of Osteopathic Medicine, Bradenton, USA.

We present the case of a collegiate football player with an extensive bilateral ligamentous knee injury history to elucidate the mechanisms and possible explanations behind why some athletes sustain recurrent injuries. We hope to initiate thought on altering rehabilitation schedules for athletes who are at an increased risk of re-injury. A 21-year-old collegiate American football player presented with a re-tear of his left anterior cruciate ligament (ACL) and medial meniscus following reconstructive surgery. Read More

JBJS Essent Surg Tech 2021 Oct-Dec;11(4). Epub 2021 Oct 7.

Department of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota.

Meniscal root tears are soft-tissue and/or osseous injuries characterized by an avulsion of, or tear within 1 cm of, the native meniscal insertion. These injuries account for 10% to 21% of all meniscal tears, affecting nearly 100,000 patients annually. Medial meniscal posterior-root tears (MMPRTs) expose the tibiofemoral joint to supraphysiologic contact pressure, decreased contact area, and altered knee kinematics similar to a total meniscectomy. Read More

J Knee Surg 2022 Jun 10. Epub 2022 Jun 10.

Department of Medicine of Sensory and Motor Organs, Division of Orthopedic Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

This study was conducted to present remnant-preserving anterior cruciate ligament (ACL) augmentation as a useful option for partial ACL injury in multiligament knee injury (MLKI) cases, which may also contribute to conserving graft resources. The present study involved patients diagnosed with MLKI at our institute from Spring 2006 to February 2021. A total of 71 MLKI cases were provided surgery due to knee instability and disability. Read More

JBJS Essent Surg Tech 2022 Jan-Mar;12(1). Epub 2022 Mar 21.

Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, Connecticut.

Tenosynovial giant cell tumor (T-GCT) and pigmented villonodular synovitis (PVNS) are interchangeable terms for an uncommon benign proliferation of synovial tissue. Although neoplastic and inflammatory origins have been hypothesized, the etiology of this condition is unknown. There is controversy regarding surgical treatment, as the open and arthroscopic approaches to synovectomy have shown comparable reported outcomes in the literature. Read More

Scanning 2022 25;2022:7348978. Epub 2022 May 25.

College of Physical Education, Fuyang Normal University, Fuyang, Anhui 236037, China.

To study the effect of football injury on knee pain based on MRI image scanning, in this paper, a total of 31 knee injuries of 29 male professional football players from December 2012 to April 2015 were used as the experimental group. The players were 23.6 ± 3. Read More

Arthrosc Tech 2022 May 22;11(5):e763-e766. Epub 2022 Apr 22.

Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Groupe Ramsay-Générale de Santé, Hopital Privé Jean Mermoz, Lyon, France.

Acute injuries of the knee medial collateral ligament complex concomitant with anterior cruciate ligament injuries are common. The exact site of the injury may be difficult to diagnose preoperatively on magnetic resonance imaging. This study describes an arthroscopic sign that helps determine the site of the knee medial collateral ligament complex injury. Read More

Res Sports Med 2022 May 27:1-5. Epub 2022 May 27.

Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

Sensitivity, specificity, and agreement between clinical and magnetic resonance imaging (MRI) gradings of the medial collateral ligament (MCL) after acute knee injury were evaluated in 362 patients. Ninety-seven per cent were injured during sports/recreation. Sensitivity and specificity of MRI for grade II or III MCL injury was 68% (95% CI 58-77%) and 90% (95% CI 86-93%), respectively. Read More

Am J Sports Med 2022 Jul 23;50(8):2083-2092. Epub 2022 May 23.

Department of Orthopaedics & Rehabilitation, University of New Mexico, Albuquerque, New Mexico, USA.

Background: Medial-sided knee injuries can lead to symptomatic valgus laxity or anteromedial rotatory instability and may require surgery, particularly in the setting of cruciate tears and tibial-sided medial collateral ligament (MCL) avulsions. The LaPrade (LP) technique utilizes 2 free grafts to reconstruct the superficial MCL (sMCL) and the posterior oblique ligament (POL). An alternative MCL reconstruction devised by the senior author comprises an anatomic single-bundle reconstruction using a free graft to reconstruct the sMCL with advancement and imbrication of the posteromedial capsule/POL (MCL anatomic reconstruction with capsular imbrication [MARCI] technique). Read More

Am J Sports Med 2022 Jun 20;50(7):1815-1822. Epub 2022 May 20.

Department of Orthopaedic Surgery, The Princess Grace Hospital, London, UK.

Background: A "Stener-like" lesion of the knee is defined as a distal avulsion of the superficial medial collateral ligament (sMCL) with interposition of the pes anserinus between the ligament and its tibial insertion-a displacement impeding anatomic healing. Because of the scarcity of these injuries, the literature is limited to case reports and small case series.

Purpose: To assess the effect of surgical repair of acute Stener-like lesions of the sMCL on the following outcomes: return to preinjury level of sporting function; time to return to preinjury level of sporting function; functional performance; injury recurrence; and any other complications. Read More

Am J Sports Med 2022 Jun 5;50(7):1823-1831. Epub 2022 May 5.

Biomechanics Group, Department of Mechanical Engineering, Imperial College London, London, UK.

Background: Although a medial collateral ligament (MCL) injury is associated with anteromedial rotatory instability (AMRI) and often with an anterior cruciate ligament (ACL) injury, there has been little work to develop anteromedial (AM) reconstruction to address this laxity.

Purpose: To measure the ability of a novel "anatomic" AM reconstruction technique to restore native knee laxity for isolated AM insufficiency and combined AM plus posteromedial insufficiency.

Study Design: Controlled laboratory study. Read More

Am J Sports Med 2022 Jun 3;50(7):1832-1842. Epub 2022 May 3.

Biomechanics Group, Mechanical Engineering Department, Imperial College London, London, UK.

Background: There are many descriptions of medial collateral ligament (MCL) reconstruction, but they may not reproduce the anatomic structures and there is little evidence of their biomechanical performance.

Purpose: To investigate the ability of "anatomic" MCL reconstruction to restore native stability after grade III MCL plus posteromedial capsule/posterior oblique ligament injuries in vitro.

Study Design: Controlled laboratory study. Read More

Orthopedics 2022 Apr 29:1-7. Epub 2022 Apr 29.

Intraoperative medial collateral ligament (MCL) injury during total knee arthroplasty (TKA) is a serious complication. External bracing and/or conversion to a constrained implant has previously been studied. The technique of using an internal high-strength suture brace to augment an MCL repair has been evaluated in the nonarthroplasty patient and could provide an alternate solution. Read More

Orthop J Sports Med 2022 Apr 8;10(4):23259671221086669. Epub 2022 Apr 8.

Midwest Orthopaedics at Rush, Rush University Medical Center, Chicago, Illinois, USA.

Background: Anterior cruciate ligament (ACL) tears are often associated with other ligamentous injuries. The side-to-side difference in heel height can represent a valuable diagnostic tool in the setting of multiligamentous injuries.

Purpose: To assess in a cadaveric model how sequential sectioning of the static stabilizing structures of the knee (ACL, fibular collateral ligament [FCL], popliteus tendon [PLT], popliteofibular ligament [PFL], and medial collateral ligament [MCL]) influences heel-height measurements when comparing groups undergoing initial transection of the ACL versus FCL and to assess posterior tibial slope after sequential sectioning. Read More

J Orthop Case Rep 2021 Nov;11(11):39-46

Department of Orthopaedics, Ganga Medical Centre and Hospital, Coimbatore, Tamil Nadu, India.

Introduction: Anterior fractures of the tibial plateau are either compression or avulsion injuries. Anterior compression fractures of the tibial plateau (ACFT) are rare being traditionally described as involving the rim and often associated with ligament injuries. We have presented 7seven cases of the "large'' type of ACFT, an uncommon pattern of ACFT. Read More

Eur Rev Med Pharmacol Sci 2022 03;26(6):1860-1867

Department of Orthopedics, College of Medicine, Majmaah University, Al-Majmaah, Saudi Arabia.

Objective: The current study was aimed at reviewing the literature systematically to educe enhanced understanding of various techniques, sequels, as well as complications after percutaneous MCL lengthening through the procedure of arthroscopy of the knee; moreover, we utilize this clinical data that will help surgeons to encompass this technical gesticulation into their day-to-day surgical practice.

Materials And Methods: The inclusion criteria were framed as per the internationally standardized PICOS framework, as recommended by PRISMA guidelines. The study population included adults who underwent arthroscopic knee surgery for sMCL lengthening. Read More

Orthop J Sports Med 2022 Mar 24;10(3):23259671221085272. Epub 2022 Mar 24.

Department of Anatomy, Kansas City University, Kansas City, Missouri, USA.

Background: An iatrogenic injury to the infrapatellar branch of the saphenous nerve (IPBSN) is a common precipitant of postoperative knee pain and hypoesthesia.

Purpose: To locate potential safe zones for incision by observing the patterns and pathway of the IPBSN while examining the relationship of its location to sex, laterality, and leg length.

Study Design: Descriptive laboratory study. Read More

Pain Physician 2022 03;25(2):E319-E329

Division of Rheumatology, Allergy, Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

Background: Medial knee pain is a common complaint in the adult population. When conservative measures fail, intraarticular knee corticosteroid injections are often offered through the superolateral approach into the suprapatellar recess to provide short-term relief. However, some patients fail to respond and require alternative approaches. Read More

J Orthop Res 2022 Mar 14. Epub 2022 Mar 14.

J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, Florida, USA.

With age, susceptibility to osteoarthritis (OA) and OA-related pain and disability increases. Like in OA patients, gait patterns in rodent OA models shift to protect the injured limb during loading. However, unlike in OA patients, it is unknown how age affects gait changes in rodent OA models. Read More

Arthrosc Tech 2022 Mar 8;11(3):e291-e300. Epub 2022 Feb 8.

Gelenkpunkt Innsbruck, Austria.

The main principles of the present medial collateral ligament (MCL) reconstruction techniques are (1) to approximate the natural anatomy and (2) to restore the main passive restraining structures in anteromedial and posteromedial knee instability. Therefore, we describe a technique using a flat tendon graft instead of tubular grafts with point-to-point bone fixation. Moreover, we address the deep MCL, a relevant restraint to anteromedial instability. Read More

Biomed Mater Eng 2022 Mar 1. Epub 2022 Mar 1.

Graduate School of Health Sciences, Niigata University, Niigata, Japan.

Background: Knowledge of the biomechanics of the normal collateral ligaments is important to secure optimal stability of the knee following injury. Various in vitro methods have been described in evaluating the biomechanics of these ligaments. However, a method of direct evaluation has not been reported. Read More

J Clin Orthop Trauma 2022 Apr 18;27:101807. Epub 2022 Feb 18.

Sports Injury and Arthroscopy Division, Orthopaedics, Kasturba medical college, Manipal, Manipal academy of Higher education, Manipal, India.

Traditionally, while managing ligament injuries around the knee, medial side injuries are frequently overlooked or considered '' with very little influence on overall knee stability outcomes. However, much has changed in the recent past, and like the lateral side of the knee, it is gaining considerable attention. It is now well known that the Medial collateral ligament and Posteromedial corner are fundamentally two distinct structures that differ in anatomy and biomechanics. Read More

Arthroplasty 2021 Apr 2;3(1). Epub 2021 Apr 2.

Arthroplasty Unit, Division of Orthopaedic Surgery, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, South Africa.

Background: A review of the literature revealed that only 9 total knee replacements were performed on patients with osteogenesis imperfecta (OI), with one being a revision procedure of a periprosthetic fracture. Of the 9 primary procedures, all used cemented prostheses, and 3 patients had an osteotomy at the same procedure. Our patient required a hinged prosthesis because of collateral ligament incompetence and is the first such case reported in the literature. Read More

Arch Orthop Trauma Surg 2022 Mar 1. Epub 2022 Mar 1.

School of Clinical Medicine, Tsinghua University, Beijing, China.

Introduction: The lateral femoral notch sign (LFNS) and the kissing contusion (KC) are two indirect signs of anterior cruciate ligament (ACL) injuries. They can be used to diagnose ACL injuries.

Materials And Methods: A total of 1000 patients were enrolled in this study, including 500 patients with ACL injuries who assigned to experimental group and 500 patients with meniscal tear (MT) who allocated to control group. Read More

Adv Orthop 2022 29;2022:1766401. Epub 2022 Jan 29.

Centro de Innovación, Clínica MEDS, Santiago, Chile.

Introduction: Traditional techniques can enlarge the medial tibiofemoral joint space width (JSW) for meniscal repairs, but a remnant ligament laxity may be developed. Alternatively, the debridement of the inner retinaculum layer may result in a balanced JSW without causing extra-ligament damage (retinaculum layers II and collateral ligament).

Purpose: The purpose of this study was to determine whether a concentric arthroscopic debridement of the inner retinaculum layer increases the tibiofemoral JSW in patients with meniscal injuries. Read More

Arthrosc Tech 2022 Jan 27;11(1):e69-e78. Epub 2021 Dec 27.

Yawata Medical Center, Department of Orthopaedic Surgery, Komatsu, Japan.

Biplanar open wedge high tibial osteotomy (OWHTO) has become common since the introduction of OWHTO-specific plates. However, the management of soft tissues, including skin, the pes anserinus, and the superficial medial collateral ligament (sMCL) release vary among surgeons. We introduce an OWHTO methodology that avoids pes incision and repair, uses bone substitute insertion into the opening gap and includes management of soft tissues to minimize complications. Read More

Am J Sports Med 2022 03 2;50(4):968-976. Epub 2022 Feb 2.

Department of Orthopaedics, Aarhus University Hospital, Aarhus, Denmark.

Background: Although previous studies have reported good short-term results for superficial medial collateral ligament (sMCL) reconstruction, whether an augmented MCL repair is clinically equivalent remains unclear.

Purpose/hypothesis: The purpose of this study was to compare clinical outcomes between randomized groups that underwent sMCL augmentation repair and sMCL autograft reconstruction. The hypothesis was that there would be no significant differences in objective or subjective outcomes between groups. Read More

Cureus 2021 Dec 22;13(12):e20597. Epub 2021 Dec 22.

Department of Orthopedics and Traumatology, Ankara Training and Research Hospital, Ankara, TUR.

Background Knee arthroscopy is the most common surgery performed to treat meniscal injuries. The pie crust (PC) technique is applied during knee arthroscopy to increase joint vision of the medial femorotibial compartment and reduce the risk of iatrogenic damage. Medial collateral ligament (MCL) release is applied in the PC technique. Read More

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2022 Jan;36(1):10-17

Department of Sports Medicine, Anhui Provincial Corps Hospital of Chinese People's Armed Police Force, Hefei Anhui, 230001, P. R. China.

Objective: To investigate the short-term effectiveness of one-stage anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and posterolateral complex (PLC) reconstruction combined with medial collateral ligament repair for KD-Ⅳ knee dislocation.

Methods: Between January 2018 and June 2020, 9 patients with KD-Ⅳ knee dislocation were treated. Of 9 cases, 7 were male and 2 were female with an average age of 32. Read More

Orthop J Sports Med 2022 Jan 7;10(1):23259671211047860. Epub 2022 Jan 7.

II Clinica Ortopedica e Traumatologica, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.

Background: A combined injury to the anterior cruciate ligament (ACL) and medial collateral ligament (MCL) is a common injury pattern encountered during clinical practice. Recent systematic reviews have found no consensus on the optimal method of managing this combined ligament injury pattern, and no long-term studies with modern techniques are available in the literature.

Purpose: To compare 2 groups of patients who underwent isolated ACL reconstruction in terms of failures and clinical scores at long-term follow-up. Read More

BMC Musculoskelet Disord 2022 Jan 13;23(1):43. Epub 2022 Jan 13.

Department of Spinal Orthopaedics, General Hospital of Ningxia Medical University, No. of 804, Shengli Street, Yinchuan, 750004, China.

Background: Magnetic resonance imaging (MRI) is widely used for the evaluation of knee injuries, however, the accuracy of MRI in classifying multiple ligament knee injuries (MLKIs) remains unknown. This study aimed to investigate the accuracy of MRI in diagnosing and classifying acute traumatic MLKIs, we hypothesize that MRI had high accuracy in detecting and classifying MLKIs.

Methods: The clinical data of 97 patients who were diagnosed with acute traumatic MLKIs and managed by multi-ligament reconstruction between 2012 and 2020 were retrospectively reviewed. Read More