The American journal of knee surgery
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This investigation was undertaken to identify the structures torn within the medial retinaculum and localize the injury site anatomically following acute lateral dislocation of the patella in a cadaver model. The patellae of 10 fresh-frozen cadavers were translated laterally 135% of the patella width on a universal testing instrument. Magnetic resonance imaging (MRI) was performed on all specimens prior to testing and immediately following testing. ⋯ The pathology demonstrated in this study may explain the diversity of injury seen clinically. Whereas an avulsion fracture from the patella may represent the medial patellomeniscal ligament, a femoral-sided retinacular tear may represent the medial patellofemoral ligament. This may lead to future refinements of surgical options and anatomic restoration of the damaged structure.
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It has been recommended that reconstruction of the anterior cruciate ligament (ACL) in skeletally immature patients should not violate the physeal plate of the distal femur or proximal tibia as growth irregularity might occur. Despite the lack of conclusive evidence that tendon transfers through growth areas cause growth irregularity, recent reports suggest that ligament reconstruction be performed in a nonisometric fashion to avoid violating the growth plate. Eight skeletally immature individuals underwent ligament reconstruction (average age: 14 years 9 months) and were reviewed retrospectively at an average of 32 months postsurgery. ⋯ Ligament reconstruction using the semitendinosus and gracilis autograft can give excellent results in the skeletally immature individual. There appears to be minimal risk to the growth areas of the tibia or the femur at the knee. The graft can be safely passed through anatomically accurate bony drill holes in an arthroscopic fashion without apparent damage.
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Randomized Controlled Trial Multicenter Study Clinical Trial
The use of the Cryo/Cuff versus ice and elastic wrap in the postoperative care of knee arthroscopy patients.
Pain and swelling, which may lead to inhibition of the extensor mechanism and ultimately a delay in rehabilitation, are common complications of knee arthroscopy. Cryotherapy is the most often used means of decreasing both knee edema and discomfort. A number of methods have been used to provide cold pressure dressings, including ice and elastic bandages. ⋯ The Cryo/Cuff patients also expressed a high level of satisfaction with the effectiveness and convenience of the therapy. There were no differences between either group in the amount of pain reported, or preoperative and postoperative examinations in regard to knee range of motion and thigh circumference. These results indicate that the Cryo/Cuff is a useful adjunct in the rehabilitation of knee arthroscopy patients.