The American journal of sports medicine
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There is limited insight into the mechanisms of anterior cruciate ligament injuries in alpine skiing, particularly among professional ski racers. ⋯ Based on this video analysis of 20 injury situations, the main mechanism of anterior cruciate ligament injury in World Cup alpine skiing appeared to be a slip-catch situation where the outer ski catches the inside edge, forcing the outer knee into internal rotation and valgus. A similar loading pattern was observed for the dynamic snowplow. Injury prevention efforts should focus on the slip-catch mechanism and the dynamic snowplow.
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Patellar dislocation is a common traumatic injury in the pediatric and adolescent population. The primary constraint to lateral subluxation and dislocation of the patella is the medial patellofemoral ligament (MPFL), which serves to resist lateral translation of the patella. Injury to the MPFL may predispose to recurrent dislocation but the anatomic site of injury is poorly characterized in children and adolescents. ⋯ The zone of MPFL injury in a pediatric population after primary patellar dislocation was predominantly isolated to the patellar attachment (61%), in contrast to previous literature. Twelve percent of patients had injury only at the femoral attachment, while 12% of patients had injury to both the patellar and femoral attachments. The remaining 15% had injury at multiple locations or no identifiable injury. The MRI finding that the anatomic insertion of the MPFL is distal to the physis in 93% of patients and that the MPFL is more likely to be injured at the patellar attachment has important implications in the surgical reconstruction of the MPFL in pediatric or adolescent patients.
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Achilles tendon rupture is a frequent injury in athletes and the general public. Cases of chronic rupture or poor tendon quality secondary to tendinopathy are challenging to repair primarily. Commercially available extracellular matrix materials have been utilized in recent years to augment tendon repair. ⋯ Tendon repair augmentation may allow more aggressive early rehabilitation, particularly in cases of chronic rupture or poor tendon quality. Further work is necessary to define indications for extracellular matrix graft augmentation of tendon repairs.
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Arthroscopic iliopsoas tenotomies are performed at the level of the labrum, femoral neck, and lesser trochanter. The composition and percentage of the iliopsoas muscle-tendon unit (MTU) that is released when the tendon is cut at these sites has not been reported to date. ⋯ The results of this study document that releasing the iliopsoas tendon at the lesser trochanter preserves 40% of the MTU and does not result in a complete detachment of the iliopsoas MTU.
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Randomized Controlled Trial Comparative Study
Arthroscopic reconstruction of the anterior cruciate ligament with hamstring tendon autograft and fresh-frozen allograft: a prospective, randomized controlled study.
Most studies of allograft versus autograft for anterior cruciate ligament reconstruction have been of bone-patellar tendon-bone; outcome reports evaluating anterior cruciate ligament reconstruction with hamstring tendon autograft versus allograft are rare. ⋯ Both groups of patients achieved almost the same satisfactory outcome at an average of 7.8 years of follow-up. Fresh-frozen hamstring tendon allograft is a reasonable alternative choice to autograft for anterior cruciate ligament reconstruction.