3D contour registration reveals that location-independent cartilage thickness scores and regional patterns differ between early and late follow-up periods after anterior cruciate ligament (ACL) rupture

2021 ◽  
Vol 29 ◽  
pp. S316-S317
Author(s):  
D. Fürst ◽  
W. Wirth ◽  
A. Wisser ◽  
M. Gaisberger ◽  
R. Frobell ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Cartilage Thickness ◽  
Acl Rupture ◽  
Regional Patterns ◽  
Anterior Cruciate

Results of a New Treatment Concept for Concomitant Lesion of Medial Collateral Ligament in Patients with Rupture of Anterior Cruciate Ligament

2016 ◽  
Vol 30 (07) ◽  
pp. 652-658 ◽  
Author(s):  
Jochen Paul ◽  
Maximilian Haenle ◽  
Jannes Sailer ◽  
Geert Pagenstert ◽  
Lutz Wehren ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Medial Collateral Ligament ◽  
Cruciate Ligament ◽  
Acl Rupture ◽  
Treatment Concept ◽  
Collateral Ligament ◽  
Term Outcome ◽  
Anterior Cruciate ◽  
New Treatment

AbstractAnteromedial knee injury with rupture of anterior cruciate ligament (ACL) and concomitant lesion of medial collateral ligament (MCL) is common in athletes. No standardized treatment concept can be found within the literature. This study presents results of a new treatment concept for concomitant MCL lesions in patients with ACL rupture. In this study, 67 recreational athletes with ACL injury and concomitant MCL lesion were treated according to a distinct treatment concept. Patients were classified in six different types of concomitant MCL lesion depending on grade of MCL lesion and presence of anteromedial rotatory instability (AMRI). Final classification and surgical indication were determined 6 weeks posttraumatic. All patients received ACL reconstruction. MCL was treated by surgical or conservative regime due to type of concomitant MCL lesion. International Knee Documentation Committee (IKDC), AMRI, and Lysholm scores were evaluated both preoperatively and after 6 weeks, 16 weeks, 12 months, and 18 months postoperatively. All patients could be uniquely classified and treated according to the introduced treatment concept. AMRI was verifiable in patients with grade II and III MCL lesions. All patients showed good to excellent clinical results at the follow-up examinations. In all 67 patients (100%), the findings were graded as normal or nearly normal according to the IKDC knee examination form. Lysholm score averaged 93.9 at final follow-up. The introduced treatment concept showed good results on short-term outcome and provides a sufficient treatment strategy for concomitant MCL lesions in athletes with ACL rupture.

scholarly journals Coper Classification Early After Anterior Cruciate Ligament Rupture Changes With Progressive Neuromuscular and Strength Training and Is Associated With 2-Year Success: The Delaware-Oslo ACL Cohort Study

2019 ◽  
Vol 47 (4) ◽  
pp. 807-814 ◽  
Author(s):  
Louise M. Thoma ◽  
Hege Grindem ◽  
David Logerstedt ◽  
Michael Axe ◽  
Lars Engebretsen ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cohort Study ◽  
Strength Training ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Acl Rupture ◽  
Level Of Evidence ◽  
Before And After ◽  
Anterior Cruciate

Background: Some athletes demonstrate excellent dynamic stability after anterior cruciate ligament (ACL) rupture and return to sport without ACL reconstruction (ACLR) (copers). Others demonstrate persistent instability despite rehabilitation (noncopers) and require surgical stabilization. Testing to determine coper classification can identify potential copers early after rupture. It is unclear how coper classification changes after a brief intervention and how early classification relates to long-term outcomes. Purpose: (1) To evaluate the consistency of early coper classification (potential coper vs noncoper) before and after progressive neuromuscular and strength training (NMST) among athletes early after acute ACL rupture and (2) to evaluate the association of early coper classification with 2-year success after ACL rupture. Study Design: Cohort study; Level of evidence, 2. Methods: This was a prospective analysis from the Delaware-Oslo ACL Cohort Study, composed of athletes consecutively enrolled early after ACL rupture. Participants (n = 271) were tested and classified as potential copers or noncopers according to established criteria before and after a 10-session NMST program. Success 2 years after ACLR or nonoperative rehabilitation was defined as meeting or exceeding sex- and age-matched norms for knee function, no ACL graft rupture, and ≤1 episode of giving way within the previous year. The McNemar test evaluated changes in coper classification pre- to posttraining. Logistic regression adjusted for baseline characteristics was used to evaluate the association of early coper classification and surgical status with 2-year success. Results: Of 300 athletes enrolled, 271 (90%) completed the posttraining data collection, and 219 (73%) returned for the 2-year follow-up. The coper classifications were different between time points: nearly half of those classified initially as noncopers became potential copers ( P < .001). At the 2-year follow-up, 66% of the ACLR group and 74% of the nonoperative group were successful. Athletes who were potential copers posttraining and chose ACLR or nonoperative rehabilitation had 2.7 (95% CI, 1.3-5.6) and 2.9 (95% CI, 1.2-7.2) times the odds of success, respectively, as compared with noncopers who chose ACLR. Conclusion: Coper classification improved after NMST; more athletes became potential copers. Athletes who were potential copers after NMST were more likely to succeed 2 years later regardless of whether they had surgery, strongly supporting the addition of NMST before ACLR. Persistent noncopers fared poorly, indicating that more intensive rehabilitation may be needed.

An In-Depth Analysis of Graft Rupture and Contralateral Anterior Cruciate Ligament Rupture Rates After Pediatric Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 48 (10) ◽  
pp. 2395-2400
Author(s):  
Christopher J. DeFrancesco ◽  
Brendan M. Striano ◽  
Joshua T. Bram ◽  
Keith D. Baldwin ◽  
Theodore J. Ganley
Keyword(s):  
Anterior Cruciate Ligament ◽  
Survival Analysis ◽  
Cruciate Ligament ◽  
Case Series ◽  
Acl Rupture ◽  
Kaplan Meier ◽  
Graft Rupture ◽  
Cumulative Rate ◽  
Anterior Cruciate

Background: Reported rates of graft rupture and contralateral anterior cruciate ligament (ACL) rupture after ACL reconstruction (ACLR) are higher among pediatric patients than adults. Previous series may have underestimated postoperative event risk because of small sample sizes and high proportions of dropouts. Purpose: To calculate rates of graft rupture and contralateral ACL rupture after ACLR in a large pediatric series. Study Design: Case series; Level of evidence, 4. Methods: ACLRs performed in our tertiary care children’s hospital system over a period of >7 years were identified through billing review. Cases were sorted based on operative technique, with all-epiphyseal ACLRs considered separately. Transphyseal ACLRs were divided into 2 groups based on patient age, with a cutoff of 16 years. Clinic follow-up data as well as prospectively collected survey data were used to note graft rupture and contralateral ACL rupture events. Rates of graft rupture and contralateral ACL rupture were calculated using Kaplan-Meier survival analysis. Results: The final data set included 996 patients. A total of 161 patients underwent all-epiphyseal ACLR. Of the remaining transphyseal surgeries, 504 patients were <16 years of age at the time of surgery and 331 were ≥16 years. The 4-year cumulative rate of graft rupture via Kaplan-Meier survival analysis was 19.7% among all patients. The rate was 18.2% among all-epiphyseal ACLRs, 21.6% among transphyseal ACLRs in patients <16 years, and 16.4% among transphyseal ACLRs in patients ≥16 years ( P = .855). Survival analysis estimated the 4-year cumulative rate of contralateral ACL rupture at 12.0% among all patients: 6.63% among all-epiphyseal ACLRs, 15.7% among transphyseal ACLRs in patients <16 years, and 8.05% among transphyseal ACLRs in patients ≥16 years ( P = .093). Conclusion: This is the largest series of pediatric ACLRs yet reported, and it shows that the risks of another ACL injury after first-time ACLR are higher than previously reported. The risk of contralateral ACL rupture was lower than that for graft rupture. Our methods, including prospective follow-up surveys and survival analysis to generate cumulative rate estimates, provide a best-practice example for future case series calculations. Our results provide insight into the postoperative course of pediatric patients undergoing ACLR and are crucial for preoperative patient and family counseling. Understanding these risks may also influence return-to-play decisions.

Anterior Cruciate Ligament Rupture Associated with Cardiomyopathy in Three Cats

1991 ◽  
Vol 4 (01) ◽  
pp. 35-37 ◽  
Author(s):  
G. O. Janssens ◽  
D. L. Janssens ◽  
L. A. A. Janssens
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Anterior Cruciate Ligament Rupture ◽  
Acl Rupture ◽  
Thoracic Radiography ◽  
Ligament Rupture ◽  
Cruciate Ligament Rupture ◽  
Previous Trauma ◽  
History Of ◽  
Anterior Cruciate

SummaryOver a period of 14 years, three cats with anterior cruciate ligament (ACL) rupture were seen in our practice. In all, the rupture had occurred without a history of previous trauma. All were treated surgically. All died within a period of 14 days. The reason of death was in all cases cardiomyopathy. We now suggest that cats with rupture of the anterior cruciate ligament undergo an electrocardiographic recording and eventually an thoracic radiography before surgery is considered. We also suggest that cats with ACL rupture should preferably be treated conservatively.

The Femoral Footprint Position of the Anterior Cruciate Ligament Might Be a Predisposing Factor to a Noncontact Anterior Cruciate Ligament Rupture

2019 ◽  
Vol 47 (14) ◽  
pp. 3365-3372 ◽  
Author(s):  
Dimitris Dimitriou ◽  
Zhongzheng Wang ◽  
Diyang Zou ◽  
Tsung-Yuan Tsai ◽  
Naeder Helmy
Keyword(s):  
Anterior Cruciate Ligament ◽  
Matched Control ◽  
Cruciate Ligament ◽  
Magnetic Resonance Images ◽  
Small Sample ◽  
Transverse Plane ◽  
Acl Rupture ◽  
Coronal Plane ◽  
Predisposing Factor ◽  
Anterior Cruciate

Background: Although the femoral tunnel position is crucial to anatomic single-bundle anterior cruciate ligament (ACL) reconstruction, the recommendations for the ideal femoral footprint position are mostly based on cadaveric studies with small sample sizes, elderly patients with unknown ACL status, and 2-dimensional techniques. Furthermore, a potential difference in the femoral ACL footprint position and ACL orientation between ACL-ruptured and ACL-intact knees has not been reported in the literature. Hypothesis: The femoral ACL footprint position and ACL orientation vary significantly between ACL-ruptured and matched control ACL-intact knees. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Magnetic resonance images of the knees of 90 patients with an ACL rupture and 90 matched control participants who had a noncontact knee injury without an ACL rupture were used to create 3-dimensional models of the femur and tibia. The ACL footprints were outlined on each model, and their positions (normalized to the lateral condyle width) as well as ACL orientations were measured with an anatomic coordinate system. Results: The femoral ACL footprint in patients with an ACL rupture was located at 36.6% posterior and 11.2% distal to the flexion-extension axis (FEA). The ACL orientation was 46.9° in the sagittal plane, 70.3° in the coronal plane, and 20.8° in the transverse plane. The ACL-ruptured group demonstrated a femoral ACL footprint position that was 11.0% more posterior and 7.7% more proximal than that of the control group (all P < .01). The same patients also exhibited 5.7° lower sagittal elevation, 3.1° higher coronal plane elevation, and 7.9° lower transverse plane deviation (all P < .01). The optimal cutoff value of the femoral ACL footprint position to prevent an ACL rupture was at 30% posterior and 12% distal to the FEA. Conclusion: The ACL femoral footprint position might be a predisposing factor to an ACL rupture. Patients with a >30% posterior and <12% distal position of the femoral ACL footprint from the FEA might have a 51.2-times increased risk of an ACL rupture.

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