Value of Preoperative MRI and Examination under Anesthesia for Differentiating Complete from Partial Anterior Cruciate Ligament Tears

2018 ◽  
Vol 32 (07) ◽  
pp. 620-623 ◽  
Author(s):  
Leonardo Cavinatto ◽  
Sunny Gupta ◽  
Craig Morgan ◽  
Arthur R. Bartolozzi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
Case Series ◽  
Single Bundle ◽  
Partial Tears ◽  
Prospective Case Series ◽  
Magnetic Resonance Imaging Mri ◽  
Anterior Cruciate ◽  
Patient Prognosis

AbstractPartial tears of the anterior cruciate ligament (ACL) recently regained attention due to a better understanding of the two distinct bundles of the ligament and the possibility of single-bundle reconstruction procedures. An accurate diagnosis is important as it influences treatment options and patient prognosis. The aim of this study was to evaluate the value of examination under anesthesia (EUA) and magnetic resonance imaging (MRI) for differentiating partial from complete ACL tears. For this purpose, this prospective case series included 95 consecutive patients undergoing primary ACL reconstruction surgeries. MRI, EUA, and MRI combined with EUA were performed preoperatively, and results were compared with arthroscopy. Our data showed that ACL lesions were diagnosed as partial tears in 42.1% (n = 40) of EUA, 23.2% (n = 22) of MRI, and 11.6% (n = 11) of arthroscopies. EUA and MRI demonstrated sensitivity of 100 and 90.1%, and specificity of 65.5 and 85.6%, respectively. Combined EUA and MRI demonstrated sensitivity of 100% and specificity of 83.1%. Our study revealed that preoperatively MRI and EUA may help surgeons early identify partial ACL tears and influence treatment decisions.

A prospective evaluation of clinical and functional outcome of single bundle anatomic anterior cruciate ligament reconstruction with hamstrings autograft

2020 ◽  
pp. 1-17
Author(s):  
Saeed Ahmed Shaikh ◽  
Naveed Ahmed ◽  
Salman Adil ◽  
Allah Rakhio Jamali
Keyword(s):  
Anterior Cruciate Ligament ◽  
Functional Outcomes ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Single Bundle ◽  
Acl Injuries ◽  
Lysholm Knee Score ◽  
Anterior Cruciate ◽  
Multiligamentous Injury

Abstract A case series was conducted at the Department of Orthopaedic surgery, Jinnah Postgraduate Medical Centre, Karachi, from July 2016 to June 2018, to evaluate the functional and clinical outcome of arthroscopic anatomic anterior cruciate ligament (ACL) reconstruction with hamstrings autograft. Patients aged 17 years and above with anterior cruciate ligament (ACL) injuries of duration three months or older, diagnosed on history and clinical examination and confirmed on Magnetic Resonance Imaging were prospectively recruited from outpatient department. Patients with multiligamentous injury were excluded. Information on patient’s demographics such as age, duration of injury and mechanism of injury were recorded. In addition, graft length and diameter, associated injuries of lateral or medical menisci were noted peroperatively. Patients were followed for a minimum of 12 months. The functional outcomes were assessed thorough lysholm knee score, and Tegner activity scale.Continuous...  

scholarly journals Day surgery for anterior cruciate ligament reconstruction in children: a prospective study on feasibility and satisfaction

2019 ◽  
Vol 13 (1) ◽  
pp. 100-106 ◽  
Author(s):  
D. Barbier ◽  
D. N’Dele ◽  
M. Bennis ◽  
C. Thevenin-Lemoine ◽  
J. Sales De Gauzy ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Day Surgery ◽  
Cruciate Ligament Reconstruction ◽  
Proper Patient Selection ◽  
Prospective Case Series ◽  
Anterior Cruciate

Purpose To evaluate the feasibility of day surgery anterior cruciate ligament reconstruction (ACLR) in children. Our hypothesis was that proper patient selection, adequate information and a streamlined clinical pathway would allow for a safe and satisfactory procedure. Methods A total of 20 patients, seven girls and 13 boys, who underwent outpatient ACLR at mean age of 14 years (8 to 16) were included in this single institution prospective case series. Surgery took place under simple general anesthesia while analgesia protocol combined local anesthesia, oral analgesics for the postoperative period and compressive cryotherapy. The main failure criterion was the inability to return home the day of surgery or the need for rehospitalization during the first week after discharge. Secondary evaluation parameters were the rate of postoperative complications, postoperative pain, quality of life (QOL) and patients’ satisfaction outcome questionnaire (PSOQ) at postoperative day 1, 7 and 31. Results Of the 20 patients included, only one failed the ambulatory mode. The mean PSOQ score was, respectively for children and parents, 91.4% and 90.7% at day 7 and 94.6% and 95.7% at one month. Postoperative QOL at day 7 was very satisfying for all patients. Two minor early complications were reported. Both of the late complications, which included one partial wound dehiscence and one persistent knee swelling, resolved spontaneously. Conclusion This study indicates that, in a targeted and well-informed population, day surgery for children ACLR yields high level of patient and family satisfaction in a safely manner. Level of evidence IV, prospective case series.

Lateral location of the tibial tunnel increases lateral meniscal extrusion after anatomical single-bundle anterior cruciate ligament reconstruction

2019 ◽  
Vol 4 (6) ◽  
pp. 285-289
Author(s):  
Takeshi Oshima ◽  
Samuel Grasso ◽  
Aaron Beach ◽  
Brett Fritsch ◽  
David A Parker
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Tibial Tunnel ◽  
Case Series ◽  
Single Bundle ◽  
Characteristic Analysis ◽  
Meniscal Extrusion ◽  
Level Of Evidence ◽  
Anterior Cruciate

IntroductionThe tibial footprint of the anterior cruciate ligament (ACL) overlaps with the anterior lateral meniscal root (ALMR), and there is a possibility that an anatomical tibial tunnel reaming might damage the attachment of ALMR. The aim of this study was to investigate the relationship between tibial tunnel location and lateral meniscal extrusion (LME) after anatomical single-bundle ACL reconstruction.MethodsA prospectively collected database and associated intraoperative findings for 153 patients undergoing primary anatomical ACL reconstruction between October 2014 and July 2016 were investigated. Those cases with no meniscal injury seen at surgery and meeting the criteria (52/153) were included. Tibial plateau length (TPL), width (TPW), tibial tunnel location and LME were evaluated from postoperative high-resolution MRI. The location of the centre of the tibial tunnel was evaluated by the position relative to the medial tibial eminence with two measures, the medial–lateral distance (MLD) and anterior–posterior distance. These measures were expressed as a percentage of the TPW and TPL, respectively. The LME was also expressed as a percentage of TPW and correlated with tibial tunnel location.ResultsThere was a positive correlation between percentage of LME (%LME) and percentage of MLD (%MLD) (r=0.478; p<0.001). Applying receiver operating characteristic analysis, we determined that a cut-off value of 4 %MLD was significant. The mean percentage of LME was 1.20 for >4 %MLD, compared with 0.17 for ≤4 %MLD (p<0.001). No significant correlation was found between %LME and clinical outcomes at 1-year follow-up.ConclusionLateral location of the tibial tunnel increases the rate of LME after single-bundle ACL reconstruction.Level of evidenceLevel IV, Case series.

Reconstruction of the Anterior Cruciate Ligament Using Ruler-Assisted Positioning of the Femoral Tunnel Relative to the Posterior Apex of the Deep Cartilage: A Single-Center Case Series

2021 ◽  
Author(s):  
Yan Dong ◽  
Jiaguang Tang ◽  
Peng Cui ◽  
Songpo Shen ◽  
Guodong Wang ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Case Series ◽  
Single Bundle ◽  
Tunnel Position ◽  
Axis Direction ◽  
Femoral Tunnel Position ◽  
Anterior Cruciate

AbstractThe techniques available to locate the femoral tunnel during anterior cruciate ligament (ACL) reconstruction have notable limitations. To evaluate whether the femoral tunnel center could be located intraoperatively with a ruler, using the posterior apex of the deep cartilage (ADC) as a landmark. This retrospective case series included consecutive patients with ACL rupture who underwent arthroscopic single-bundle ACL reconstruction at the Department of Orthopedics, Beijing Tongren Hospital between January 2014 and May 2018. During surgery, the ADC of the femoral lateral condyle was used as a landmark to locate the femoral tunnel center with a ruler. Three-dimensional computed tomography (CT) was performed within 3 days after surgery to measure the femoral tunnel position by the quadrant method. Arthroscopy was performed 1 year after surgery to evaluate the intra-articular conditions. Lysholm and International Knee Documentation Committee (IKDC) scores were determined before and 1 year after surgery. The final analysis included 82 knees of 82 patients (age = 31.7 ± 6.1 years; 70 males). The femoral tunnel center was 26 ± 1.5% in the deep-shallow (x-axis) direction and 31 ± 3.1% in the high-low (y-axis) direction, close to the “ideal” values of 27 and 34%. Lysholm score increased significantly from 38.5 (33.5–47) before surgery to 89 (86–92) at 1 year after surgery (p < 0.001). IKDC score increased significantly from 42.5 (37–47) before surgery to 87 (83.75–90) after surgery (p < 0.001). Using the ADC as a landmark, the femoral tunnel position can be accurately selected using a ruler.

The Learning Curve in Arthroscopic ACL Reconstruction. The impact on the Surgical Time and Postoperative Clinical Results

2018 ◽  
Vol 69 (10) ◽  
pp. 2874-2876
Author(s):  
Teodor Negru ◽  
Stefan Mogos ◽  
Ioan Cristian Stoica
Keyword(s):  
Anterior Cruciate Ligament ◽  
Learning Curve ◽  
Clinical Outcomes ◽  
Positive Impact ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Single Bundle ◽  
Surgical Time ◽  
Anterior Cruciate ◽  
The Impact

Rupture of the anterior cruciate ligament (ACL) is a common injury. The objective of the current study was to evaluate if the learning curve has an impact on surgical time and postoperative clinical outcomes after anatomic single-bundle anterior cruciate ligament reconstruction (ACLR) using an outside-in tunnel drilling hamstrings technique. The learning curve has a positive impact on surgical time but has no influence on postoperative clinical outcomes at short time follow-up.

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