scholarly journals Komparativna analiza polozaja kalema u butnoj kosti posle rekonstrukcije prednjeg ukrstenog ligamenta kolena tehnikom kroz prednje-unutrasnji portal i tehnikom kroz golenjacu

2013 ◽  
Vol 60 (2) ◽  
pp. 81-85
Author(s):  
Vladimir Harhaji ◽  
Srdjan Ninkovic ◽  
Zoran Milojevic ◽  
Viktor Till ◽  
Vladimir Ristic ◽  
...  
Keyword(s):  
Control Method ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Anteromedial Portal ◽  
Transtibial Technique ◽  
Acl Injuries ◽  
Knee Ligament ◽  
X Ray ◽  
The Difference ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) is the most common surgically treated knee ligament. If we take into account the fact that incidence of ACL injuries is growing, it is clearly that the interest of orthopedic surgeons for this pathology is also growing. Increasing number of this operations leads to increasing of complications, which requires its analysis. One of the most common failure of ACL reconstruction is a bad position of the graft in the femoral condyle. This study aimed to analyze the positioning of the graft in to the femur by two generally accepted techniques - transtibial technique and technique through the antero-medial portal. The analysis included postoperative radiographs in 60 patients, of whom 30 were operated by transtibial technique and 30 by technique through anteromedial portal. Radiographic analysis involved the measurement of the AP digital imaging, the tunnel projection X ray measurements and measurements of the computed tomography (CT), which was here a control method. The accuracy of measurement was set at 0.5? or 1 min. All radiographs were made in the same way according to the literature. The results showed that the neoligaments were placed lower in the femoral condyle by technique through anteromedial portal than by transtibial technique, and the difference was statistically significant (on tunnel X ray by anteromedial portal screws were average placed at 50.0? and 10:20 am, and by transtibial technique at 37.5? or 10:45 am). Based on the results, it was concluded that the neoligaments were positioned closer to its anatomical position by technique through anteromedial portal.

Review of Jones (1963) on ‘Reconstruction of the anterior cruciate ligament. A technique using the central one-third of the patellar ligament’

2019 ◽  
Vol 4 (6) ◽  
pp. 338-344
Author(s):  
Nicola Maffulli ◽  
Antonio Oliviero
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patellar Tendon ◽  
Femoral Condyle ◽  
Cruciate Ligament ◽  
Quadriceps Tendon ◽  
Tendon Graft ◽  
Patellar Ligament ◽  
Patellar Tendon Graft ◽  
Knee Ligament ◽  
Anterior Cruciate

This classic discusses the original publication ‘Reconstruction of the anterior cruciate ligament (ACL). A technique using the central one-third of the patellar ligament’ on the Jones procedure. Published in 1963 in the ‘Journal of Bone and Joint Surgery American Volume’, it was inspired by pioneering surgeons in the field of knee ligament reconstruction. Jones introduced a technique that reconstructed the ACL using the middle third of the patella tendon, leaving it attached to a strip of patella and quadriceps tendon to obtain the necessary length. The strip of patellar tendon was then introduced and secured in a tunnel drilled in an inside-out fashion through the lateral femoral condyle. Although with time technological advances and clinical and biomechanical studies led to profound modifications of the technique described in the original article, the concepts introduced by Jones are still at the base of all the reconstructive techniques of the ACL using a patellar tendon graft.

Knee ligament mechanical properties are not influenced by estrogen or its receptors

2006 ◽  
Vol 290 (5) ◽  
pp. E1034-E1040 ◽  
Author(s):  
Stuart J. Warden ◽  
Leanne K. Saxon ◽  
Alesha B. Castillo ◽  
Charles H. Turner
Keyword(s):  
Mechanical Properties ◽  
Cruciate Ligament ◽  
Neuromuscular Control ◽  
High Rate ◽  
Null Mutation ◽  
Sprague Dawley ◽  
Gene Encoding ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Anterior Cruciate

Women are at greater risk of tearing their knee anterior cruciate ligament (ACL) than men participating in similar athletic activities. There is currently no conclusive explanation for this disparity; however, as ACL injuries in women have been linked with estrogen fluctuations during the menstrual cycle, one hypothesis is that estrogen has a direct detrimental effect on knee ligament mechanical properties. This study investigated the influence of estrogen and its receptors (ERα and ERβ) on knee ligament mechanical properties. This was achieved by testing the viscoelastic and tensile mechanical properties of knee medial collateral ligaments (MCL) and ACLs from: 1) male Sprague-Dawley rats treated with either estrogen (17α-ethynylestradiol; 0.03 mg/kg) or an ERα-specific agonist (propyl pyrazole triol; 2 mg/kg), and 2) female mice with a null mutation of the gene encoding for ERβ. Estrogen treatment had no significant effects on the viscoelastic or tensile mechanical properties of the rat MCL or ACL. Similarly, pharmacological stimulation of ERα using a selective agonist in rats and genetic modulation of ERβ by null mutation of its gene in mice did not influence MCL or ACL properties. These data indicate that estrogen does not have a major direct effect on ligament mechanical properties. Energies for the prevention of the disproportionately high rate of knee ligament injuries in women may be better spent focusing on more established and modifiable risk factors, such as abnormalities in neuromuscular control about the knee.

scholarly journals EXTRA-ARTICULAR RECONSTRUCTION ASSOCIATED WITH THE ANTERIOR CRUCIATE LIGAMENT IN BRAZIL

2019 ◽  
Vol 27 (4) ◽  
pp. 202-206
Author(s):  
Camilo Partezani Helito ◽  
Carlos do Amaral Junior ◽  
Danilo Bordini Camargo ◽  
Marcelo Batista Bonadio ◽  
Jose Ricardo Pecora ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Pivot Shift ◽  
Cruciate Ligament ◽  
Positive Perception ◽  
Transtibial Technique ◽  
Level Of Evidence ◽  
Acl Injuries ◽  
Reconstruction Methods ◽  
Routine Basis ◽  
Anterior Cruciate

ABSTRACT Objective: To assess the knowledge and technical preferences of Brazilian knee surgeons in relation to the treatment of Anterior Cruciate Ligament (ACL) injuries using intra-articular reconstruction in combination with extra-articular reconstruction. Methods: A questionnaire consisting of 16 questions about intra-articular ACL reconstruction in combination with extra-articular procedures and about the Anterolateral Ligament (ALL) was applied at the 48th Brazilian Congress of Orthopedics. Results: One hundred thirty-seven surgeons answered the questionnaire. Most surgeons perform 10-30 ACL reconstructions per year, with the transtibial technique appearing as the most common. Most surgeons find some percentage of residual pivot-shift after reconstructions, but the minority performs extra-articular procedures on a routine basis. The main indications for extra-articular reconstruction are revision and profuse pivot-shift cases. Most surgeons consider the ALL a true ligament, but 46.7% with less biomechanical importance and 32.3% with greater importance in knee stability. However, 91.4% had a positive perception of the reconstruction of this structure. Conclusion: Although the preferred technique is still the transtibial procedure, combined anatomical reconstructions already make up more than 50% of cases. Extra-articular reconstructions associated with the ACL are still performed by the minority of Brazilian surgeons, but 91.4% of them report having had a positive perception with their reconstruction. Level of Evidence III, Descriptive Study.

Influence of Early Ovariohysterectomy on the Mechanical Properties of Rabbit Medial Collateral Ligament

2007 ◽  
Author(s):  
Gail M. Thornton ◽  
Soraya J. Bailey ◽  
Xinxin Shao ◽  
Douglas Morck ◽  
David A. Hart ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Female Athletes ◽  
Cruciate Ligament ◽  
Fibroblast Proliferation ◽  
Collateral Ligaments ◽  
Collateral Ligament ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Clear Explanation ◽  
Anterior Cruciate

Female athletes have significantly higher incidence of anterior cruciate ligament (ACL) injuries than males participating in similar sports [1]. To date, no clear explanation has emerged for this disparity. However, hormonal differences may provide an explanation because some ACL injuries have been linked to physiologic fluctuations in estrogen levels over the menstrual cycle [2]. Receptors for estrogen have been identified in rabbit and human ACLs and medial collateral ligaments (MCLs) [3]. Increased estrogen levels caused decreased fibroblast proliferation and collagen synthesis in cell cultures from human and rabbit ACLs [4]. Since fibroblasts maintain collagen production and degradation in ligaments and collagen is the major load-bearing component of ligaments, estrogen may affect knee ligament mechanical properties.

scholarly journals Review Article: Validity of the KT-1000 Knee Ligament Arthrometer

2009 ◽  
Vol 17 (1) ◽  
pp. 77-79 ◽  
Author(s):  
S Arneja ◽  
J Leith
Keyword(s):  
Cruciate Ligament ◽  
Review Article ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Predictive Values ◽  
Medline Search ◽  
Anterior Tibial ◽  
Kt 1000 ◽  
Anterior Cruciate ◽  
Injured Knee

The KT-1000 knee arthrometer (KT-1000) is an objective instrument to measure anterior tibial motion relative to the femur for anterior cruciate ligament (ACL) reconstruction. Four studies between 1950 and 2007 regarding validity of the KT-1000 were identified using a Medline search. One had interpretable information on sensitivities, specificities, and predictive values to validate the instrument as a diagnostic tool in patients with acute or chronic ACL injuries. Three had limitations in methodology. We suggest that the KT-1000 should be used with caution as an objective instrument. Rather, using a KT-1000 score derived by subtracting the anterior tibial motion relative to the femur of the injured knee to that of the uninjured knee may be more appropriate as a dichotomous diagnostic test with a threshold of 2 or 3 mm.

scholarly journals Application and Surgical Technique of ACL Reconstruction Using Worldwide Registry Datasets: What Can We Extract?

2021 ◽  
Vol 7 (1) ◽  
pp. 2
Author(s):  
Ulrike Wittig ◽  
Georg Hauer ◽  
Ines Vielgut ◽  
Patrick Reinbacher ◽  
Andreas Leithner ◽  
...  
Keyword(s):  
Cruciate Ligament ◽  
Knee Injuries ◽  
Epidemiological Data ◽  
Surgical Reconstruction ◽  
Acl Injuries ◽  
Knee Ligament ◽  
Graft Choice ◽  
Anterior Cruciate ◽  
The Uk ◽  
Country Specific

Anterior cruciate ligament (ACL) injuries are among the most common knee injuries. The purpose of this study was to compare surgical reconstruction of the ACL between different countries and regions in order to describe differences regarding epidemiological data, reconstruction frequency, and graft choice. A systematic literature search was performed using the ACL study group website in order to identify the relevant knee ligament registers. Four national registries were included, comprising those from Sweden, the UK, New Zealand, and Norway. A large variation was found concerning the total number of primary ACL reconstructions with a reported range from 4.1 to 51.3 per 100,000 inhabitants. The country-specific delay between injury and reconstruction varied between an average of 6.0 months and 17.6 months. The leading sports activities resulting in ACL injury included soccer, alpine skiing, handball, rugby, and netball. Moreover, a strong variability in graft choice for primary reconstruction was found. The comparison of ACL registers revealed large differences, indicating different clinical implications regarding conservative or surgical therapy and choice of the preferable graft. ACL registers offer a real-world clinical perspective with the aim to improve quality and patient safety by investigating factors associated with subsequent surgical outcomes.

Sign in / Sign up

Export Citation Format

Share Document