The American journal of sports medicine
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Repair of the medial patellofemoral ligament (MPFL) for acute patellar instability has recently become popular, with good clinical success rates reported in the literature. Usually, a lateral retinacular release (LRR) is added to the medial repair in an effort to "rebalance" the patella. In the native knee, however, isolated LRR reduces the force required to displace the patella laterally and may be an undesirable component of instability surgery. ⋯ According to this study, LRR may not be routinely appropriate as a part of the stabilizing procedure to address acute patellar dislocation when the MPFL is avulsed from the patella.
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Randomized Controlled Trial
Two- to 4-year follow-up to a comparison of home versus physical therapy-supervised rehabilitation programs after anterior cruciate ligament reconstruction.
There have been no long-term follow-up studies comparing a predominantly home-based rehabilitation program with a standard physical therapy program after anterior cruciate ligament (ACL) reconstruction. Demonstrating the long-term success of such a cost-effective program would be beneficial to guide future rehabilitation practice. ⋯ This long-term study upholds the short-term findings of the original randomized clinical trial by demonstrating that patients who participate in a predominantly home-based rehabilitation program in the first 3 months after ACL reconstruction have similar 2- to 4-year outcomes compared with those patients who participate in a more clinically supervised program.
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Comparative Study
Comparison of single- and double-bundle anterior cruciate ligament reconstructions in restoration of knee kinematics and anterior cruciate ligament forces.
Anterior cruciate ligament (ACL) deficiency alters 6 degrees of freedom knee kinematics, yet only anterior translation and internal rotation have been the primary measures in previous studies. ⋯ Both single-bundle and double-bundle techniques cannot restore the rotational laxities and the ACL force distributions of the intact knee.
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Bone-to-tendon healing in the shoulder can be unpredictable. Biologic augmentation, through the implementation of adult mesenchymal stem cells, may improve this healing process. ⋯ We have established a reliable, reproducible protocol for isolating CTPs in the operating room. These cells may have the potential to enhance the healing process after rotator cuff repair.
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Comparative Study
IKDC or KOOS: which one captures symptoms and disabilities most important to patients who have undergone initial anterior cruciate ligament reconstruction?
Knee-specific patient-reported outcome measures are frequently used after anterior cruciate ligament reconstruction but little is known about whether they measure outcomes important to patients. ⋯ Overall, the IKDC items outperformed the KOOS items on all of the 5 criteria with the exception of the frequency-importance product for patients who were 12 months after anterior cruciate ligament reconstruction. The KOOS Function in Sports/Recreation and Knee-Related Quality of Life subscales outperformed the IKDC for the total cohort as well as for male and female subgroups. However, differences in individual items were not always evident from either total scale or subscale ratings. Studies should use patient-reported outcomes that reflect patients' most important concerns and further prospective longitudinal research is required in this area.