Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Oct 2017
Meta AnalysisHamstring Autograft versus Patellar Tendon Autograft for ACL Reconstruction: Is There a Difference in Graft Failure Rate? A Meta-analysis of 47,613 Patients.
Bone-patellar tendon-bone (bone-tendon-bone) and four-strand hamstring tendon grafts (hamstring) are the most commonly utilized autografts for primary anterior cruciate ligament (ACL) reconstruction. Existing clinical trials, registry studies, and meta-analyses offer conflicting opinions regarding the most favorable graft choice. ⋯ Level III, therapeutic study.
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Clin. Orthop. Relat. Res. · Oct 2017
Variations in Knee Kinematics After ACL Injury and After Reconstruction Are Correlated With Bone Shape Differences.
The factors that contribute to the abnormal knee kinematics after anterior cruciate ligament (ACL) injury and ACL reconstruction remain unclear. Bone shape has been implicated in the development of hip and knee osteoarthritis, although there is little knowledge about the effects of bone shape on knee kinematics after ACL injury and after ACL reconstruction. QUESTIONS/QUESTIONS: (1) What is the relationship between bony morphology with alterations in knee kinematics after ACL injury? (2) Are baseline bone shape features related to abnormal knee kinematics at 12 months after ACL reconstruction? ⋯ Level II, therapeutic study.
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Clin. Orthop. Relat. Res. · Oct 2017
Randomized Controlled TrialDoes the FIFA 11+ Injury Prevention Program Reduce the Incidence of ACL Injury in Male Soccer Players?
The FIFA 11+ injury prevention program has been shown to decrease the risk of soccer injuries in men and women. The program has also been shown to decrease time loss resulting from injury. However, previous studies have not specifically investigated how the program might impact the rate of anterior cruciate ligament (ACL) injury in male soccer players. ⋯ Level I, therapeutic study.
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Clin. Orthop. Relat. Res. · Oct 2017
Rotational Laxity Control by the Anterolateral Ligament and the Lateral Meniscus Is Dependent on Knee Flexion Angle: A Cadaveric Biomechanical Study.
Injury to the anterolateral ligament (ALL) has been reported to contribute to high-grade anterolateral laxity after anterior cruciate ligament (ACL) injury. Failure to address ALL injury has been suggested as a cause of persistent rotational laxity after ACL reconstruction. Lateral meniscus posterior root (LMPR) tears have also been shown to cause increased internal rotation of the knee. ⋯ Injury to the ALL and/or LMPR may contribute to high-grade anterolateral laxity after ACL injury. The LMPR and the ALL, along with the iliotibial tract, appear to act in concert as secondary stabilizers of anterolateral rotation and could be considered as the "anterolateral corner" of the knee.
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Clin. Orthop. Relat. Res. · Oct 2017
Randomized Controlled TrialReport of the Primary Outcomes for Gait Mechanics in Men of the ACL-SPORTS Trial: Secondary Prevention With and Without Perturbation Training Does Not Restore Gait Symmetry in Men 1 or 2 Years After ACL Reconstruction.
Movement asymmetries during walking are common after anterior cruciate ligament (ACL) injury and reconstruction and may influence the early development of posttraumatic osteoarthritis. Preoperative neuromuscular training (like perturbation training, which is neuromuscular training requiring selective muscle activation in response to surface perturbations) improves gait asymmetries and functional outcomes among people who are ACL-deficient, but the effect of postoperative perturbation training on gait mechanics after ACL reconstruction is unknown. ⋯ Level II, therapeutic study.