The American journal of sports medicine
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Reconstruction of the medial patellofemoral ligament has recently become popular for restoring patellofemoral stability. Femoral insertion site anatomy of the medial patellofemoral ligament has been described. This anatomical insertion has been inferred to be the isometric point in medial patellofemoral ligament reconstruction, but data about radiographic landmarks for a postoperative or intraoperative control are missing. ⋯ This radiographic point may be useful both intraoperatively and postoperatively.
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Randomized Controlled Trial Clinical Trial
Patellar tendon or semitendinosus tendon autografts for anterior cruciate ligament reconstruction: a prospective, randomized study with a 7-Year follow-up.
The aim of the study was to compare the results after arthroscopic anterior cruciate ligament (ACL) reconstruction using central-third bone-patellar tendon-bone (BTB) autografts and triple/quadruple semitendinosus (ST) autografts. ⋯ Seven years after ACL reconstruction, the subjective and objective outcomes were similar after using the central-third BTB autograft and triple/quadruple ST autograft. Furthermore, no difference in terms of donor-site morbidity was found between the 2 groups.
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Menstrual cycle phase has been correlated with risk of noncontact anterior cruciate ligament injury in women. The mechanism by which hormonal cycling may affect injury rate is unknown. ⋯ Because knee and hip joint loading is unaffected by cyclic variations in hormone levels, the observed difference in injury rates is more likely attributable to persistent differences in strength, neuromuscular coordination, or ligament properties.
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The choice of graft material for anterior cruciate ligament reconstruction remains controversial. Despite the need for well-controlled, long-term outcome studies comparing patellar tendon with hamstring grafting, few studies have followed results for more than 5 years. ⋯ Six-year outcomes were very satisfactory irrespective of graft source. However, reconstruction using the hamstring tendons resulted in improved functional performance and a lower incidence of osteoarthritis.
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Operative techniques for the management of juvenile osteochondritis dissecans lesions of the knee include drilling, internal fixation, fragment removal, and chondral resurfacing. ⋯ Given the relatively high healing rate, good functional outcome, and low complication rate, the authors advocate internal fixation of unstable juvenile osteochondritis dissecans lesions of the knee, even for detached lesions and in patients with a history of surgery for the osteochondritis dissecans lesion.