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The psychological readiness to return to sports of patients with anterior cruciate ligament reconstruction preoperatively and 6 months postoperatively.

Phys Ther Sport 2021 Apr 30;50:114-120. Epub 2021 Apr 30.

Clinical Center for Sports Medicine and Sports Dentistry, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan.

Objective: To determine the association of psychological readiness to return to sports preoperative and 6 months post-reconstruction in athletes with anterior cruciate ligament (ACL) injury.

Design: Retrospective cohort study.

Setting: Clinical center of sports medicine. Read More

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Open Versus Endoscopic Osteotomy of Posterosuperior Calcaneal Tuberosity for Haglund Syndrome: A Retrospective Cohort Study.

Orthop J Sports Med 2021 Apr 19;9(4):23259671211001055. Epub 2021 Apr 19.

Institute of Sports Medicine, Beijing Key Laboratory of Sports Injury, Peking University Third Hospital, Beijing, People's Republic of China.

Background: Although endoscopic calcaneoplasty and retrocalcaneal debridement have been extensively applied to treat Haglund syndrome, evidence of the value of the endoscopic procedure remains to be fully established.

Purpose/hypothesis: The purpose of this study was to compare the postoperative outcomes and the amount of osteotomy between open and endoscopic surgery for the treatment of Haglund syndrome. It was hypothesized that endoscopic calcaneoplasty would lead to higher patient satisfaction and lower complication rates compared with open surgical techniques. Read More

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Effect of Leg Dominance on Medium- to Long-Term Functional Outcomes, Quality of Life, and Revision Rates After Isolated ACL Reconstruction.

Orthop J Sports Med 2021 Apr 12;9(4):2325967121995808. Epub 2021 Apr 12.

Department of Orthopedics and Traumatology, Faculty of Medicine, Erciyes University, Kayseri, Turkey.

Background: The effect of leg dominance on short-term functional outcomes and return to sports after arthroscopic anterior cruciate ligament reconstruction (ACLR) has been evaluated. However, postoperative medium- to long-term recovery and revision rates are not well known.

Purpose: To investigate whether leg dominance affects medium- to long-term clinical and functional scores and revision rates after ACLR. Read More

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All-inside repair of bucket handle meniscus tears - Mid-term outcomes with postoperative magnetic resonance imaging.

Knee 2021 Apr 30;30:195-204. Epub 2021 Apr 30.

Department of Orthopaedic Surgery, Changi General Hospital, Singapore.

Purpose: The purpose of this study was to evaluate our results of bucket handle meniscus tear (BHMT) repairs with an all-inside repair technique using postoperative radiological imaging to evaluate meniscus reduction and healing and use them as criteria for evaluation of repair success.

Methods: Prospective recruitment of 20 patients with 21 BHMT repairs performed with an all-inside techniqueover a period from 2013 to 2015. All patients had an International Knee Documentation Committee (IKDC) Subjective Knee Form (SKF), Lysholm Score, Knee Injury and Osteoarthritis Outcome Score (KOOS) and Tegner Activity Level Scale obtained pre-operatively and at a minimum of 24 months after surgery. Read More

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Use of the forgotten joint score (FJS)-12 to evaluate knee awareness after isolated anterior cruciate ligament reconstruction with and without meniscus repair or partial meniscectomy.

Eur J Orthop Surg Traumatol 2021 May 3. Epub 2021 May 3.

Department of Forensic Medicine, Tepecik Training and Research Hospital, İzmir, Turkey.

Purpose: The aim of this study was to compare knee awareness, based on the FJS-12 score, among three patient groups: Anterior cruciate ligament reconstruction (ACLR), ACLR + meniscus repair and ACLR + partial meniscectomy. The relationship between FJS-12 scores and scores on other instruments (Lysholm Knee Scoring Scale, Tegner Activity Level Scale, KOOS and WOMAC) was also evaluated.

Methods: Forty-three patients were divided into group A (isolated ACLR) group B (ACLR + meniscectomy) and group C (ACLR + meniscus repair). Read More

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Repair versus reconstruction for proximal anterior cruciate ligament tears: a study protocol for a prospective multicenter randomized controlled trial.

BMC Musculoskelet Disord 2021 Apr 30;22(1):399. Epub 2021 Apr 30.

Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.

Background: For active patients with a tear of the anterior cruciate ligament (ACL) who would like to return to active level of sports, the current surgical gold standard is reconstruction of the ACL. Recently, there has been renewed interest in repairing the ACL in selected patients with a proximally torn ligament. Repair of the ligament has (potential) advantages over reconstruction of the ligament such as decreased surgical morbidity, faster return of range of motion, and potentially decreased awareness of the knee. Read More

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Treatment of osteochondritis dissecans of the patella in adolescents with nanofractured autologous matrix-induced chondrogenesis (NAMIC): A report of five cases.

Knee 2021 Apr 27;30:157-162. Epub 2021 Apr 27.

Knee Unit, Department of Orthopedic Surgery and Traumatology, Parc Taulí University Hospital, Institut d'Investigació i Innovació Parc Taulí CSPT, Autonomous University of Barcelona, Sabadell, Spain.

Purpose: Osteochondritis dissecans (OCD) of the patella is a very rare affliction. The aim of this case series is to evaluate the effectiveness of the Nanofractured Autologous Matrix-Induced Chondrogenesis (NAMIC) technique for the treatment of OCD in young adults.

Methods: Five consecutive patients with patellar osteochondral lesions treated with NAMIC were prospectively studied. Read More

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Pre-operative Joint Inflammation has no Bearing on Outcome of Arthroscopic Anterior Cruciate Ligament Reconstruction at 1-Year Follow-Up; a Prospective Study.

Indian J Orthop 2021 Apr 8;55(2):360-367. Epub 2020 Jun 8.

Department of Biochemistry, Government Medical College Hospital, Chandigarh, 160030 India.

Background: To study the effect of pre-operative joint inflammation on clinical outcome at 1 year follow-up following ACL reconstruction surgery.

Methods: Male patients, aged 18-40 years, suffering from isolated ACL injury were included. All patients were randomly divided into two groups based on the type of graft used: Group A: semitendinosus gracilis graft with preserved insertions (STG-PI), Group B: bone-patellar tendon-bone graft (BPTB). Read More

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Factors Affecting the Femoral Cartilage Thickness After Anterior Cruciate Ligament Reconstruction.

Indian J Orthop 2021 Apr 28;55(2):352-359. Epub 2020 Sep 28.

Department of Physical, Medicine and Rehabilitation, Faculty of Medicine, Istanbul Medipol University, TEM Avrupa Otoyolu Göztepe Çıkışı No: 1, Bagcilar, Istanbul, 34214 Turkey.

Background: This study aimed to evaluate the changes in the distal femoral cartilage thickness in patients that underwent anterior cruciate ligament reconstruction (ACLR) and to analyze their association with concomitant meniscal surgery, knee muscle strength, kinesophobia, and physical activity level.

Methods: The demographic characteristics and surgical data of 47 male patients that underwent unilateral ACLR (mean, 27.55 ± 5. Read More

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The presence of high-grade pivot shift test preoperatively is associated with inferior functional outcomes.

Phys Sportsmed 2021 May 11:1-5. Epub 2021 May 11.

Department of Orthopaedics, Government Medical College Hospital, Chandigarh, India.

: The effect of high-grade preoperative pivot shift test on outcomes of anterior cruciate ligament (ACL) reconstruction surgery is not very well established. The present study was conducted to study the factors associated with high-grade pivot shift test and effect of high-grade preoperative pivot shift test on functional outcomes after ACL reconstruction surgery.: Three hundred and sixty-two patients who underwent primary ACL reconstruction surgery were enrolled in the study. Read More

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Psychological, physical and social factors influence decision to return to sport after revision ACL reconstruction with BPTB graft.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 25. Epub 2021 Apr 25.

Gloucestershire Hospitals NHS Foundation Trust, Sandford Rd, Cheltenham, GL53 7AN, UK.

Purpose: There is limited evidence in literature regarding the patient-reported factors that influence their return to sport (RTS) in revision anterior cruciate ligament reconstruction (ACLR). The medium-term results of a prospective consecutive cohort of patients undergoing single- and two-stage revision ACLR with bone patellar tendon bone graft (BPTB) and patient-reported factors that influence their decision to return to sport are presented in this study.

Methods: Seventy-two patients were included in this prospective study. Read More

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Efficacy of Autologous Platelet-Rich Plasma Injections for Grade 3 Symptomatic Degenerative Meniscal Lesions: A 1-Year Follow-up Prospective Study.

Sports Health 2021 Apr 24:19417381211011074. Epub 2021 Apr 24.

Department of Musculoskeletal Disorders, School of Medicine and Surgery, University of Salerno, Salerno, Italy.

Background: Platelet-rich plasma (PRP) injections have been proposed as a biologic option to provide symptomatic relief and delay surgery in patients with degenerative joint disease of osteoarthritis (OA). The efficacy of autologous PRP on symptomatic degenerative meniscal lesions (DMLs) has never been investigated.

Hypothesis: We hypothesized that patients with symptomatic DMLs without OA undergoing autologous PRP injections experience a significant clinical improvement at 12 months. Read More

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Salvage Revision Hip arthroscopy including Remplissage Improves Patient Reported Outcomes after Cam Over-Resection.

Arthroscopy 2021 Apr 19. Epub 2021 Apr 19.

Purpose: To evaluate outcomes of arthroscopic hip remplissage with folded iliotibial band (ITB) allograft to treat cam over resection METHODS: Patients who underwent arthroscopic ITB hip remplissage from May 2013 to April 2018 were prospectively evaluated. Pre- and post-operative patient reported outcome scores were compared and included SF12 PCS (Physical Health Composite Score), SF12 MCS (Mental Health Composite Score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Modified Harris Hip Score (mHHS), Hip Outcome Score (HOS) (Activities of Daily Living (ADL) and Sport). Post-operative Tegner Activity Scale and patient satisfaction (1 - 10) were also evaluated. Read More

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Evaluation of the 'Spaarne soft tissue procedure' as a treatment for recurrent patellar dislocations: a four-in-one technique.

J Exp Orthop 2021 Apr 20;8(1):31. Epub 2021 Apr 20.

Department, of Orthopaedic Surgery, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, the Netherlands.

Purpose: The 'Spaarne soft tissue procedure', is a 4-in-1 soft tissue procedure that treats recurrent patellar dislocations in the young and active population. The procedure has not yet described elsewhere. The purpose of this study is to analyse the redislocation rate and to evaluate the postoperative knee function and patient satisfaction. Read More

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Anterior Locking Plate Osteosynthesis of Patellar Factures - Analysis of Complications and Functional Outcome.

Z Orthop Unfall 2021 Apr 19. Epub 2021 Apr 19.

Orthopaedic Clinic, Hannover Medical University (MHH), DIAKOVERE Annastift, Hannover, Germany.

Background: Tension band wiring is the standard procedure for patellar fractures, but is associated with a high rate of implant related complications and implant failure. Tension band wiring may fail, especially with multifragmentary and comminuted fractures. Plate fixation of complex patellar fractures seems to be superior to wiring, both clinically and biomechanically. Read More

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Posterior knee arthroscopy facilitates the safe and effective all-inside repair of locked bucket-handle medial meniscal tear using a suture hook technique.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 19. Epub 2021 Apr 19.

Bone Joint and Related Tissues Research Center, Akhtar Orthopedic Hospital, Shahid Beheshti University of Medical Sciences, Sharifi Manesh Street, Shariati Street, Tehran, Iran.

Purpose: This study reported the outcomes of locked bucket-handle medial meniscal tear (BHMMT) repairs using an arthroscopic posterior approach during anterior cruciate ligament (ACL) reconstruction.

Methods: Between 2011 and 2014, 48 patients with BHMMTs and ACL tears who met the eligibility criteria were enrolled in the present study. BHMMTs were assessed using a posterolateral transseptal portal and repaired using a posteromedial portal. Read More

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The Single Leg Squat Test: A "Top-Down" or "Bottom-Up" Functional Performance Test?

Int J Sports Phys Ther 2021 Apr 1;16(2):360-370. Epub 2021 Apr 1.

Colorado Mesa University.

Background: Medial knee deviation (MKD) during the single leg squat test (SLST) is a common clinical finding that is often attributed to impairments of proximal muscular structures. Investigations into the relationship between MKD and the foot and ankle complex have provided conflicting results, which may impact clinicians' interpretation of the SLST.

Purpose: The purpose of this study was to compare ankle dorsiflexion range of motion (ROM) and foot posture in subjects that perform the SLST with MKD (fail) versus without MKD (pass). Read More

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Non-anatomic repair of medial meniscus posterior root tears to the posterior capsule provided favourable outcomes in middle-aged and older patients.

Knee Surg Sports Traumatol Arthrosc 2021 Apr 9. Epub 2021 Apr 9.

Department of Orthopedic Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No.1665 Kongjiang Road, Shanghai, People's Republic of China.

Purpose: To describe a non-anatomic arthroscopic all-inside repair technique for middle-aged and older patients with medial meniscus posterior root tears (MMPRTs) and to evaluate the short- to mid-term clinical and radiologic results. The hypothesis was that this procedure would yield good clinical outcome results and structural healing in middle- and older-aged patients.

Methods: This was a retrospective study evaluating patients who had undergone MMPRT repair by suturing the meniscal root directly to the capsule, rather than by the transtibial technique, between 2013 and 2016. Read More

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Is it worth to perform initial non-operative treatment for patients with acute ACL injury?: a prospective cohort prognostic study.

Knee Surg Relat Res 2021 Apr 6;33(1):11. Epub 2021 Apr 6.

Department of Orthopedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Aran 13gil 15, Jeju-si, Jeju Self-Governing Province, 63241, South Korea.

Purpose: To evaluate the result of implementing an initial non-operative treatment program for an acute ACL injury and to find if the timing of initiating the non-operative treatment is significant.

Methods: This study included a prospective cohort of 85 consecutive patients with acute ACL injury who were treated according to the above strategy for the initial 3 months with 1-year follow-up. Clinical evaluations were made by Lysholm score, Tegner activity score, Lachman test (LT), pivot-shit test (PST), and the side to side difference (SSD) by KT-2000 arthrometer. Read More

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Autologous Matrix Induced Chondrogenesis (AMIC) Compared to Microfractures for Chondral Defects of the Talar Shoulder: A Five-Year Follow-Up Prospective Cohort Study.

Life (Basel) 2021 Mar 16;11(3). Epub 2021 Mar 16.

Department of Orthopedics and Trauma Surgery, University Clinic Aachen, RWTH Aachen University Clinic, 52064 Aachen, Germany.

Introduction: Many procedures are available to manage cartilage defects of the talus, including microfracturing (MFx) and Autologous Matrix Induced Chondrogenesis (AMIC). Whether AMIC or MFx are equivalent for borderline sized defects of the talar shoulder is unclear. Thus, the present study compared the efficacy of primary isolated AMIC versus MFx for borderline sized focal unipolar chondral defects of the talar shoulder at midterm follow-up. Read More

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Acta Ortop Bras 2021 Jan-Feb;29(1):7-11

Sports and Exercise Medicine Group, Department of Orthopedics, Rheumatology and Traumatology (DORT), SChool of Medical Sciences, University of Campinas-UNICAMP, Campinas, SP, Brazil.

Objective: To correlate clinical and intraoperative findings with the postoperative evaluation of two-stage bicruciate knee ligament reconstruction.

Methods: The study was conducted with 25 patients (20 men and 05 women) with mean age of 32.3 years, mean body mass index (BMI) of 26. Read More

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Surgical Treatment of Isolated Meniscal Tears in Competitive Male Wrestlers: Reoperations, Outcomes, and Return to Sport.

Orthop J Sports Med 2021 Jan 20;9(1):2325967120969220. Epub 2021 Jan 20.

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

Background: Wrestlers are highly active, young athletes prone to meniscal injuries that often require surgery. However, there is a lack of data evaluating the results of meniscal repair or partial meniscectomy in this cohort.

Purpose: To describe the outcomes (subjective function, return to play, complications, reoperation rates, and progression of osteoarthritis) for treatment (meniscectomy or repair) of meniscal injuries in a cohort of competitive wrestlers. Read More

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January 2021

Return-to-Sport Rate and Activity Level Are High Following Arthroscopic All-Inside Meniscal Repair With and Without Concomitant Anterior Cruciate Ligament Reconstruction: A Systematic Review.

Arthroscopy 2021 Mar 19. Epub 2021 Mar 19.

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

Purpose: To systematically review the literature of return-to-sport outcomes following all-inside meniscus repair and evaluate whether concomitant anterior cruciate ligament reconstruction (ACLR) influenced these outcomes.

Methods: A systematic review of the MEDLINE, PubMed, Embase, and Cochrane Registry of Systematic Reviews databases was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two reviewers examined all literature pertaining to sport outcomes following all-inside meniscal repair. Read More

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Treatment of acquired patella baja by proximalization tibial tubercle osteotomy significantly improved knee joint function but overall patient-reported outcome measures remain diminished after two to four years of follow-up.

Arch Orthop Trauma Surg 2021 Mar 17. Epub 2021 Mar 17.

Arcus Sportklinik, Pforzheim, Germany.

Introduction: Acquired patella baja is often characterized by painful limitation of knee joint range of motion and anterior knee pain (AKP). Only few studies have evaluated the effectiveness of surgical treatment in terms of patient-reported outcome measures (PROM's) and sports activity. Thus, the goal of this study was to assess PROM's and sports activity after proximalization tibial tubercle osteotomy (P-TTO) in patients with symptomatic patella baja. Read More

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Clinical and radiographic results after arthroscopic repair of lateral meniscus tear in lateral-depression tibial plateau fracture.

Arch Orthop Trauma Surg 2021 Mar 15. Epub 2021 Mar 15.

Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, 134-727, South Korea.

Introduction: To evaluate the clinical and radiographic results of AR/IF and meniscus repair for treating lateral meniscus (LM) tears associated with lateral tibial plateau fractures and to identify the factors associated with LM tear.

Materials And Methods: Forty-two patients with lateral plateau fractures (Schatzker types II and III) treated by AR/IF were included retrospectively. Radiographic evaluations using the Rasmussen system and computerized tomography (CT) were performed. Read More

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Knee performance and self-efficacy trajectory curves after ACL reconstruction: A longitudinal study.

Phys Ther Sport 2021 May 4;49:157-163. Epub 2021 Mar 4.

Department of Physiotherapy, Changi General Hospital, Singapore. Electronic address:

Objectives: To examine knee flexion range-of-motion, quadriceps strength, and knee self-efficacy trajectory curves over 6 months after anterior cruciate ligament reconstruction (ACLR), stratified by patients' Month-6 sports activity level.

Design: Prospective longitudinal study.

Setting: Hospital outpatient physiotherapy department. Read More

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Similar functional outcomes of arthroscopic reconstruction in patients with isolated Posterior Cruciate Ligament (PCL) and combined Anterior Cruciate Ligament (ACL) and PCL tears.

J Clin Orthop Trauma 2021 May 19;16:65-69. Epub 2020 Dec 19.

Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.

Background: Posterior Cruciate Ligament (PCL) injuries seldom occur in isolation and majority occurs in conjugation with other ligament injuries. Posterior Cruciate Ligament (PCL) reconstruction continues to be taken into consideration as a complicated surgical procedure, with heterogeneity in literature regarding clinical and functional outcomes in isolated PCL and combined ACL and PCL injuries.

Methods: The retrospective evaluation of patients with isolated PCL reconstruction (group 1) and combined Anterior Cruciate Ligament (ACL) and PCL reconstruction (group 2) was performed. Read More

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Comparable Clinical and Radiologic Outcomes Between an Anatomic Tunnel and a Low Tibial Tunnel in Remnant-Preserving Posterior Cruciate Ligament Reconstruction.

Orthop J Sports Med 2021 Feb 23;9(2):2325967120985153. Epub 2021 Feb 23.

Department of Orthopaedic Surgery, Korea University Ansan Hospital, Ansan-si, Gyeongki-do, Republic of Korea.

Background: There is currently no consensus on the optimal placement of the tibial tunnel for remnant-preserving posterior cruciate ligament (PCL) reconstruction.

Purpose/hypothesis: The purpose of this study was to compare the clinical and radiologic outcomes of remnant-preserving PCL reconstruction using anatomic versus low tibial tunnels. We hypothesized that the outcomes of low tibial tunnel placement would be superior to those of anatomic tibial tunnel placement at the 2-year follow-up after remnant-preserving PCL reconstruction. Read More

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February 2021

Medial meniscus posterior root repair reduces the extruded meniscus volume during knee flexion with favorable clinical outcome.

Knee Surg Sports Traumatol Arthrosc 2021 Mar 11. Epub 2021 Mar 11.

Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, 2-5-1 Shikatacho, Kitaku, Okayama, 700-8558, Japan.

Purpose: The volume of medial meniscus (MM) extrusion at 10° and 90° knee flexions using three-dimensional (3D) magnetic resonance imaging (MRI) and assessed relevant clinical outcomes at 1-year follow-up were evaluated.

Methods: Twenty-four patients who underwent MM posterior root repair were retrospectively reviewed. At 10° and 90° knee flexions, the meniscal extrusion distance and volume were measured using 3D meniscus models constructed by SYNAPSE VINCENT®. Read More

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