Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association
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Comparative Study
Outcomes of anterior cruciate ligament reconstruction in patients with Workers' Compensation claims.
A general perception exists that outcomes of orthopaedic procedures in patient's with Workers' Compensation claims fare worse than those of patients without such claims. We retrospectively reviewed the outcomes of anterior cruciate ligament (ACL) reconstruction in patients who have Workers' Compensation claims. This minimum 2-year follow-up study analyzed the occupational, functional, and objective results of patients who underwent arthroscopic-assisted anterior cruciate ligament (ACL) reconstruction. ⋯ The results of the current study show that ACL reconstruction leads to predictable functional and occupational results in those patients with work-related injuries. All of our patients were able to return to work. The hypothesis that Workers' Compensation compromises the results of ACL reconstruction was not observed in this study.
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Case Reports
Inflammatory foreign-body reaction to an arthroscopic bioabsorbable meniscal arrow repair.
Various arthroscopic meniscal repair techniques have been developed in recent years to preserve meniscal function. We report the case of a patient with a failed arthroscopic meniscal repair demonstrating an inflammatory foreign-body reaction to bioabsorbable meniscal arrows.
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Avulsion fractures of the tibial tuberosity are uncommon injuries. They usually occur during athletic activities in adolescents. ⋯ Only two cases of avulsion fractures of tibial tuberosity have previously been reported with associated damages to menisci. We report a type III fracture of the tibial tuberosity associated with tear of the medial meniscus.
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The aim of this dissection study on cadaver and amputated specimens was to determine the position of the infrapatellar nerves in the anterior knee region, and to investigate whether it would be possible to harvest the patellar tendon through two small vertical incisions, leaving the infrapatellar nerves undamaged and the major part of the paratenon intact. The infrapatellar nerve did not pass through the area between the apex of the patella and the tibial tubercle in 1 of 60 specimens. The nerve passed through this area as one branch in 15 of 60 specimens, as two branches in 37 of 60, as three in 6 of 60, and as four in 1 of 60 specimens. ⋯ In 19 of 20 specimens in which the harvesting procedure was performed, the infrapatellar nerve or the nerve branches were undamaged. The length of the undamaged paratenon was 27 mm (+/- 23 mm [2 SD]). This study showed that it was possible to harvest consistent bone-patellar tendon-bone autografts through two vertical 25-mm incisions, leaving the infrapatellar nerve undamaged and the paratenon partially intact in the majority of the cadaver and amputated specimens.
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Three cases of posterior cruciate ligament (PCL) laxity without posterolateral rotatory instability had magnetic resonance imaging scans that documented the structural continuity of the PCL. Tibial PCL recession was effective in eliminating symptomatic laxity in 1 case and lacked efficacy in the other 2 cases.