Posterior Cruciate Ligament Reconstruction in the Multiple Ligament Injured Knee
J Knee Surg DOI: 10.1055/s-0039-3402792Multiligamentous knee injuries are challenging to treat and diagnose. Posterior cruciate ligament (PCL) injuries are commonly found in the constellation of injuries included in a multiligamentous knee injury and are caused by a posteriorly directed force on the proximal tibia with relation to the femoral condyles. A thorough history and physical examination should be performed to evaluate for associated neurovascular injuries and associated ligamentous, chondral, or bony injuries. Nonsurgical management is reserved for patients who are critically ill or have very low activity demands. Surgical reconstruction is recommended for most patients with multiligamentous knee injuries. The PCL reconstruction can be undertaken with several different graft options and reconstruction techniques, including the transtibial, arthroscopic tibial inlay, and open tibial inlay approach. The literature has a paucity of data regarding outcomes among the various reconstructive options, so the optimal surgical technique has not been established. [...] Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.Article in Thieme eJournals: Table of contents | Abstract | Full text
Publication date: Available online 31 March 2020Source: Arthroscopy TechniquesAuthor(s): Alejandro Espejo-Baena, Alejandro Espejo-Reina, María Josefa Espejo-Reina, Joaquina Ruiz-Del Pino
Publication date: Available online 31 March 2020Source: Arthroscopy TechniquesAuthor(s): Avi Shah, Shital N. Parikh
Publication date: April 2020Source: Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology, Volume 20Author(s): Suthee Tharakulphan, Chayut Chaiperm, Adinun Apivatgaroon, Thananit Sangkomkamhang
ConclusionThere was no difference in the risk of revision ACL reconstruction between the two femoral tunnel drilling techniques at short-term follow-up. We observed minor differences in patient-reported outcomes at 1-year follow-up favouring the anteromedial portal technique, which may not be clinically relevant. Surgeons can achieve good clinical outcomes with either drilling technique.Level of evidenceIII.
ConclusionIn the global surgical community, there remains a significant variability in the diagnosis, treatment, and postoperative management of PLC injuries. The number of PLC injuries treated yearly by most surgeons remains low. As global clinical consensus for PLC remains elusive, societies will need to play an important role in the dissemination of evidence-based practices for PLC injuries.Level of evidenceIV.
Publication date: Available online 30 March 2020Source: Journal of OrthopaedicsAuthor(s): Zhen Tan, Benjamins A. Hendy, Benjamin Zmistowski, Robin S. Camp, Charles L. Getz, Joseph A. Abboud, Surena Namdari
Meniscal tears are commonly observed on MRIs obtained in middle-aged and older adults, with some studies suggesting a 35% prevalence in the 50-and-older population (1). Not all tears are symptomatic, but patients with these tears often seek treatment when they experience pain, swelling, or interference with valued activities. Physical therapy (PT) and arthroscopic partial meniscectomy (APM) are among the treatment options available to these patients, with clinical trials showing similar benefits in terms of pain and functional improvement for both (2).
It is recommended that patients cease smoking before rotator cuff repair. However, not all patients want to or are able to successfully cease smoking. This raises the question if these patients should be advised to pursue surgical intervention or if surgery should be contraindicated until patients successfully cease smoking.
Authors would like to correct the errors in figure 4 legend.
ConclusionBoth tibial spine width/notch outlet length and tibial spine width/notch width index were significantly smaller in the ACL tear group when compared with the ACL intact group. The occurrence of ACL injury influenced by the variance in width between the tibial spine and the femoral intercondylar notch.Level of evidenceIII.