scholarly journals Minimally invasive technologies in the treatment of closed fractures of the intercondylar elevation of the knee: a clinical case

2015 ◽  
Vol 3 (4) ◽  
pp. 48-50
Author(s):  
Evgueny Vladimirovich Voronchikhin ◽  
Vadim Vitalievich Kozhevnikov ◽  
Ludmila Grigorievna Grigoricheva ◽  
Vadim Fedorovich Naidanov
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Minimally Invasive ◽  
Clinical Case ◽  
Cruciate Ligament ◽  
Invasive Technique ◽  
Closed Fractures ◽  
Anterior Cruciate ◽  
The Right ◽  
Federal Center

Тhis article presents a clinical case of the surgical treatment of a fracture in the intercondylar eminences of the knee joint in a 7-year-old child. Closed fractures of the intercondylar exaltation are mainly a characteristic of childhood. This type of damage occurs by dysfunction of the knee resulting from instability. Because the fracture of the intercondylar eminences of the knee joint in children is similar to the damage of the anterior cruciate ligament in adults, the current course of knee surgery is a minimally invasive technique. These include fixation of the intercondylar exaltation using video stroboscopy as well as the assistance of various implants (e.g., screw, wire, and Dacron). In the children's Department of Traumatology and Orthopedics of the Federal Center of Traumatology, Orthopedics and Endoprosthesis Replacement in Barnaul, various surgeries are performed, including arthroscopy of the right knee joint, intercondylar exaltation reposition, and fixation of the intercondylar exaltation latch Lupine (De PuyMitek).

scholarly journals Reconsidering Reciprocal Length Patterns of the Anteromedial and Posterolateral Bundles of the Anterior Cruciate Ligament During In Vivo Gait

2020 ◽  
Vol 48 (8) ◽  
pp. 1893-1899 ◽  
Author(s):  
Zoë A. Englander ◽  
Jocelyn R. Wittstein ◽  
Adam P. Goode ◽  
William E. Garrett ◽  
Louis E. DeFrate
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Functional Anatomy ◽  
Attachment Site ◽  
Attachment Sites ◽  
Biplanar Radiographs ◽  
Anterior Cruciate ◽  
The Right

Background: Some cadaveric studies have indicated that the anterior cruciate ligament (ACL) consists of anteromedial and posterolateral bundles that display reciprocal function with regard to knee flexion. However, several in vivo imaging studies have suggested that these bundles elongate in parallel with regard to flexion. Furthermore, the most appropriate description of the functional anatomy of the ACL is still debated, with the ACL being described as consisting of 2 or 3 bundles or as a continuum of fibers. Hypothesis: As long as their origination and termination locations are defined within the ACL attachment site footprints, ACL bundles elongate in parallel with knee extension during gait. Study Design: Descriptive laboratory study. Methods: High-speed biplanar radiographs of the right knee joint were obtained during gait in 6 healthy male participants (mean ± SD: body mass index, 25.5 ± 1.2 kg/m2; age, 29.2 ± 3.8 years) with no history of lower extremity injury or surgery. Three-dimensional models of the right femur, tibia, and ACL attachment sites were created from magnetic resonance images. The bone models were registered to the biplanar radiographs, thereby reproducing the in vivo positions of the knee joint. For each knee position, the distances between the centroids of the ACL attachment sites were used to represent ACL length. The lengths of 1000 virtual bundles were measured for each participant by randomly sampling locations on the attachment site surfaces and measuring the distances between each pair of locations. Spearman rho rank correlations were performed between the virtual bundle lengths and ACL length. Results: The virtual bundle lengths were highly correlated with the length of the ACL, defined as the distance between the centroids of the attachment sites (rho = 0.91 ± 0.1, across participants; P < 5 × 10-5). The lengths of the bundles that originated and terminated in the anterior and medial aspects of the ACL were positively correlated (rho = 0.81 ± 0.1; P < 5 × 10-5) with the lengths of the bundles that originated and terminated in the posterior and lateral aspects of the ACL. Conclusion: As long as their origination and termination points are specified within the footprint of the attachment sites, ACL bundles elongate in parallel as the knee is extended. Clinical Relevance: These data elucidate ACL functional anatomy and may help guide ACL reconstruction techniques.

scholarly journals Surgical Treatment of Combined Instability of the Knee Joint Caused by Damage to Three Stabilizing Ligaments (ACl, PCL, MCL). Clinical case

2021 ◽  
Vol 1 (56) ◽  
pp. 62-66
Author(s):  
Bagdat Balbosynov ◽  
◽  
Nurzhan Asanov ◽  
Marat Urazaev ◽  
Yerzhan Uteshev ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Joint Instability ◽  
Knee Injury ◽  
Clinical Case ◽  
Cruciate Ligament ◽  
Lateral Ligament ◽  
Lateral Ligaments ◽  
Anterior Cruciate ◽  
The Moment

This article presents a clinical case of combined injury of three ligaments (anterior and posterior cruciate and medial lateral ligaments) in a 46-year-old overweight woman (BMI = 38). The late diagnosed damage to the ligaments and the lack of conditions for their normal recovery led to combined instability of the knee joint and the appearance of indications for their reconstruction. At the moment, 6 weeks after the operation, the patient began to step independently on the operated limb, the range of permissible movements in the knee joint was flexion up to 90 degrees. The planned period of full recovery is 24 weeks. Key words: combined knee joint instability, posterior cruciate ligament, medial lateral ligament, anterior cruciate ligament, knee injury, clinical case.

scholarly journals Conservative Rehabilitation of Partial Anterior Cruciate Ligament Tear - A Case Report

2021 ◽  
pp. 386-394
Author(s):  
Shivani Uttamchandani ◽  
Khushboo Bhageriya ◽  
Mithushi Deshmukh
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Joint Effusion ◽  
Posterolateral Bundle ◽  
Anteromedial Bundle ◽  
Lower Limb Muscles ◽  
Functional Pain ◽  
Anterior Cruciate ◽  
The Right

The anterior cruciate ligament is one of the most important ligaments in the knee joint (ACL). The ACL is necessary for appropriate knee joint mobility and mechanics. When the ACL is torn, patients may experience issues with their knee's function, as well as instability and the sensation of 'falling away' while walking. The anterior cruciate ligament acts as a main restraint on tibia-to-femur translation (anterior shear). Depending on the angle of knee flexion, this function is allocated to either anteromedial or posterolateral bundle. When the knee is fully extended, the posterolateral bundle is tense; however, when the knee flexes, the posterolateral bundle loosens and the anteromedial bundle tightens. We report the case of a 32-year-old man who twisted his leg while jogging, resulting in a partial thickness ACL rupture and mild joint effusion along the periarticular surface of the right knee, as revealed by radiological symptoms and MRI.Conservative rehabilitation in a patient aged 32 year shows good results and so the surgery was not performed. Initially 10 weeks protocol was managed in hospital under the guidance of a therapist including strengthening, stretching and conditioning of lower limb muscles, later on as pain reduced and patient achieved functional pain free range 12 week protocol was further set for home program.

scholarly journals CONSERVATIVE REHABILITATION OF PARTIAL ANTERIOR CRUCIATE LIGAMENT TEAR FOR BETTER FUNCTIONAL OUTCOME

2021 ◽  
Vol 10 (5) ◽  
pp. 3606-3609
Author(s):  
Ragini Dadgal
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Weight Bearing ◽  
Invasive Procedure ◽  
Joint Effusion ◽  
Posterolateral Bundle ◽  
Full Extension ◽  
Anterior Cruciate ◽  
The Right

To stabilize the knee joint, the anterior cruciate ligament (ACL) is one of the important ligaments. For normal movement and mechanics of the knee joint, ACL is important. If the ACL is torn, people notice problems in stability function of knee joint and there the feeling of ‘giving away’ while weight bearing. The function of anterior cruciate ligament is to restrain translation of the tibia on the femur. However, this role is divided by either anteromedial or the posterolateral bundle, depending on the knee flexion angle. The posterolateral bundle is stretched when the knee is close to full extension; as the knee flexes, the posterolateral bundle loosens and the anteromedial bundle becomes tight. In this report, a 32-year-old male who had a history of twisting of the leg while jogging, started by him since 40 days, lead to partial thickness tear of ACL, minimal joint effusion along the periarticular surface of the right knee and was diagnosed by radiological findings and MRI. As patient was not ready for surgery, he decided to opt for physiotherapy management. The aim of this study is to study effects on functional outcomes after physiotherapy rehabilitation of ACL injury without any invasive procedure.

The Analysis of Proprioception Alteration during First Five Months after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 1 (84) ◽  
Author(s):  
Vilma Jurevičienė ◽  
Albertas Skurvydas ◽  
Juozas Belickas ◽  
Giedra Bušmanienė ◽  
Dovilė Kielė ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Angular Velocity ◽  
Knee Joint ◽  
Cruciate Ligament ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Starting Position ◽  
Angular Velocities ◽  
Anterior Cruciate

Research  background  and  hypothesis.  Proprioception  is  important  in  the  prevention  of  injuries  as  reduced proprioception  is  one  of  the  factors  contributing  to  injury  in  the  knee  joint,  particularly  the  ACL.  Therefore, proprioception appears not only important for the prevention of ACL injuries, but also for regaining full function after ACL reconstruction.Research aim. The aim of this study was to understand how proprioception is recovered four and five months after anterior cruciate ligament (ACL) reconstruction.Research methods. The study included 15 male subjects (age – 33.7 ± 2.49 years) who had undergone unilateral ACL reconstruction with a semitendinosus/gracilis (STG) graft in Kaunas Clinical Hospital. For proprioceptive assessment, joint position sense (JPS) was measured on both legs using an isokinetic dynamometer (Biodex), at knee flexion of 60° and 70°, and at different knee angular velocities of 2°/s and 10°/s. The patients were assessed preoperatively and after 4 and 5 months, postoperatively.Research results. Our study has shown that the JPS’s (joint position sense) error scores  to a controlled active movement is significantly higher in injured ACL-deficient knee than in the contralateral knee (normal knee) before surgery and after four and five months of rehabilitation.  After 4 and 5 months of rehabilitation we found significantly lower values in injured knees compared to the preoperative data. Our study has shown that in injured knee active angle reproduction errors after 4 and 5 months of rehabilitation were higher compared with the ones of the uninjured knee. Proprioceptive ability on the both legs was  independent of all differences angles for target and starting position for movement. The knee joint position sense on both legs depends upon the rate of two different angular velocities and the mean active angle reproduction errors at the test of angular velocity slow speed was the highest compared with the fast angular velocity. Discussion and conclusions. In conclusion, our study shows that there was improvement in mean JPS 4 and 5 months after ACL reconstruction, but it did not return to normal indices.Keywords: knee joint, joint position sense, angular velocity, starting position for movement.

Deconstructing the Anterior Cruciate Ligament: What We Know and Do Not Know About Function, Material Properties, and Injury Mechanics

2015 ◽  
Vol 137 (2) ◽  
Author(s):  
Scott G. McLean ◽  
Kaitlyn F. Mallett ◽  
Ellen M. Arruda
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Mechanical Response ◽  
Cruciate Ligament ◽  
Complex Structure ◽  
Acute Injury ◽  
Research Attention ◽  
Increased Risk ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) injury is a common and potentially catastrophic knee joint injury, afflicting a large number of males and particularly females annually. Apart from the obvious acute injury events, it also presents with significant long-term morbidities, in which osteoarthritis (OA) is a frequent and debilitative outcome. With these facts in mind, a vast amount of research has been undertaken over the past five decades geared toward characterizing the structural and mechanical behaviors of the native ACL tissue under various external load applications. While these efforts have afforded important insights, both in terms of understanding treating and rehabilitating ACL injuries; injury rates, their well-established sex-based disparity, and long-term sequelae have endured. In reviewing the expanse of literature conducted to date in this area, this paper identifies important knowledge gaps that contribute directly to this long-standing clinical dilemma. In particular, the following limitations remain. First, minimal data exist that accurately describe native ACL mechanics under the extreme loading rates synonymous with actual injury. Second, current ACL mechanical data are typically derived from isolated and oversimplified strain estimates that fail to adequately capture the true 3D mechanical response of this anatomically complex structure. Third, graft tissues commonly chosen to reconstruct the ruptured ACL are mechanically suboptimal, being overdesigned for stiffness compared to the native tissue. The net result is an increased risk of rerupture and a modified and potentially hazardous habitual joint contact profile. These major limitations appear to warrant explicit research attention moving forward in order to successfully maintain/restore optimal knee joint function and long-term life quality in a large number of otherwise healthy individuals.

scholarly journals Effective Graft Preservation by Following a Standard Protocol for the Treatment of Knee Joint Infection after Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 32 (11) ◽  
pp. 1111-1120
Author(s):  
Robin Otchwemah ◽  
Jan-Hendrik Naendrup ◽  
Frauke Mattner ◽  
Thorsten Tjardes ◽  
Holger Bäthis ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Joint Infection ◽  
Standard Protocol ◽  
Standardized Protocol ◽  
Graft Preservation ◽  
Knee Joint Infection ◽  
Anterior Cruciate

AbstractKnee joint infections constitute a rare but devastating complication after anterior cruciate ligament (ACL) reconstruction. We hypothesized that effective infection therapy and graft preservation is possible following a standard treatment protocol. We retrospectively analyzed all patients admitted to our center with suspected infection of the knee after ACL reconstruction between 2010 and 2012. Following a standardized protocol, blood samples were drawn and synovial fluid was analyzed. Furthermore, the protocol consisted of arthroscopic lavages and debridements of the anterior and posterior joint compartments over three incisions, and targeted antibiotic therapy over a period of 6 weeks. Surgeries were repeated every 2 days until clinical signs of infections resolved, but at least two times. Mean observation period was 10 months. Forty-one patients aged 31 ( ±  9.9) years and admitted 14 ( ±  7.5) days after ACL reconstruction were included. Pathogens were found in 34 patients and coagulase-negative staphylococci were isolated most commonly (31 isolates in 28 patients). Quinolones were the most commonly used antibiotic agents. Mean number of operations was 3.8 ( ± 1.4). Following the standard protocol, primary successful infection treatment with graft preservation was possible in 37 of the included 41 patients. Graft preservation was achieved in 100% of the included patients with Gaechter stage 1 and 2 infections. Knee joint infection after ACL reconstruction was successfully treated following a standardized protocol, and graft preservation was reliably achieved especially in cases with infections at an early stage.

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