Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jan 2008
Neuromuscular and biomechanical landing performance subsequent to ipsilateral semitendinosus and gracilis autograft anterior cruciate ligament reconstruction.
The hamstrings musculature is a vital component of an intricate dynamic knee joint restraint mechanism. However, there is evidence based on research studies suggesting potential deficits to this complex mechanism due to donor site morbidity resulting from harvest of the ipsilateral semitendinosus and gracilis autograft (ISGA) for anterior cruciate ligament reconstruction (ACLR). The purpose of this retrospective research study was to investigate the effects of ISGA ACLR on neuromuscular and biomechanical performance during a single-leg vertical drop landing (VDL), a functional task and associated mechanism of anterior cruciate ligament disruption during physical activity. ⋯ However, it is evident that this specific population exhibits unique neuromuscular and biomechanical adaptations aimed to stabilize the knee previously subjected to ACL trauma and safeguard the ISGA ACLR joint. Co-contraction of quadriceps and hamstrings as well as inhibition of gastrocnemius muscle activation may serve to moderate excessive loads exposed to the intra-articular ISGA during single-leg VDLs. Furthermore, greater muscle activation of the hamstrings in conjunction with increased peak hip, knee and ankle joint flexion angles may assist in enhancing acceptance of VGRF transferred through the kinetic chain following single-leg VDLs.
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Knee Surg Sports Traumatol Arthrosc · Jan 2008
Arthroscopic all-inside repair of Palmer type 1B triangular fibrocartilage complex tears: a technical note.
Arthroscopic repair of peripheral dorso-ulnar triangular fibrocartilage complex (TFCC) lesions is now a preferred method. Both outside-in and inside-out techniques are commonly performed for repairing Palmer type 1B TFCC tear. ⋯ This all-inside technique is as simple as previously described arthroscopic techniques and also has advantages of vertical mattress suture and no additional incision. We recommend this technique as a useful alternative to the others for repairing Palmer type 1B TFCC tear.
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Knee Surg Sports Traumatol Arthrosc · Jan 2008
Case ReportsRecurrent patellar dislocation after medial patellofemoral ligament reconstruction.
We report on three cases of recurrent lateral patellar dislocation following a medial patellofemoral ligament (MPFL) reconstruction for patellar instability. In all three cases, an isolated MPFL reconstruction was performed with a double autogenous gracilis graft. The patellar fixation was done through bone tunnels. ⋯ We suggest that this complication is caused by the original underlying pathology such as dysplastic trochlea, abnormal TT-TG, patella alta and hyperlaxity, resulting a greater reliance upon the reconstructed MPFL for patellar stability. When subjected to a severe stress, the graft, which is stronger and stiffer than the original MPFL, will cause a fracture through the medial edge of the patella. This weak area results from the previous drill holes, which act as stress risers.