One sixth of primary anterior cruciate ligament reconstructions may undergo reoperation due to complications or new injuries within 2 years
AbstractPurposeTo analyse the incidence, types and risk factors for reoperation within 2 years of primary anterior cruciate ligament reconstruction (ACLR).MethodsOur clinic registry was used to identify primary ACLRs, performed from 2005 to 2015, and reoperations performed on the ipsilateral knee within 2 years at our institution. Reoperations were identified using procedural codes and analysis of medical records. A logistic regression analysis was used to evaluate risk factors for reoperation.ResultsA total of 6030 primary ACLRs were included. A total of 1112 (18.4%) reoperations performed on 1018 (16.9%) primary ACLRs were identified. The most common reoperations were screw removal (n = 282, 4.7%), meniscus procedures (n = 238, 3.9%), cyclops removal/notchplasty (n = 222, 3.7%) and reoperations due to graft rupture (n = 146, 2.4%), including revision ACLR. Age
AbstractThe purpose of this study is to evaluate patient-reported outcome measures (PROMs) in patients aged 40 years and older who underwent meniscal repair or meniscectomy. All patients aged 40 and older who underwent a meniscal repair at a single institution from 2006 to 2017 were included. Meniscal repair cases were matched with a meniscectomy control group in a 1:3 ratio, selected for an equal proporti on of concomitant ACL reconstruction in each group. PROMs, collected at a minimum follow-up of 24 months, included International Knee Documentation Committee Subjective Knee Evaluation Form (IKDC), Marx activi...
Publication date: Available online 15 September 2020Source: Arthroscopy TechniquesAuthor(s): Alexandra H. Aitchison, Lindsay M. Schlichte, Daniel W. Green, Frank A. Cordasco
The purpose of this study is to evaluate how both annual surgeon and facility volume affect the cost and outcomes of ACLR surgery. We also aimed to identify trends in how surgeon caseload predicts graft selection.
When we were asked to be guest editors for this Foot and Ankle issue of Clinics in Sports Medicine, we appreciated the magnitude of this amazing opportunity to share the expertise of our Orthopedic Foot and Ankle community with our Sports Medicine colleagues around the country. Just as our Sports Medicine colleagues have revolutionized ACL reconstruction, cartilage regeneration, arthroscopy, and rotator cuff repair, our Foot and Ankle members have led the charge for advancing syndesmotic fixation, surgical treatment of ankle instability and turf toe injuries, tendon transfers for foot drop, and innovative approaches to fra...
ConclusionsDistal hamstring tendon avulsion is a rare condition, with no consensus regarding optimal management options. Acute surgical repair leads to excellent results, with a return to pre-injury level of sporting activity.Level of evidenceIV.
ConclusionsAll-inside repair is a safe and versatile technique which can be used in the majority of meniscal tears encountered during ligament reconstruction with excellent mid-term success. Failure is seen more commonly in medial sided repairs and with failure of ACL reconstruction.Level of evidenceIV.
We read the recent editorial commentary “Meniscal Repair—Why Bother?”1 commenting on our study “Meniscus Repair Does Not Result in an Inferior Short-Term Outcome Compared With Meniscus Resection: An Analysis of 5,378 Patients With Primary Anterior Cruciate Ligament Reconstruction.”2 We have some concerns regarding the interpreta tion of the results of our study. The commentary states: “The logical conclusion for us, as readers of this article, seems that we should not bother wasting time in repairing the meniscus: let’s resect the torn part and get on with the ACLR.” This was...
The search for an isometric, anatomic, biomechanically optimal anterior cruciate ligament (ACL) reconstruction remains elusive. To better approximate the native ACL, surgeons have used a host of different graft options and repair techniques. Surgical techniques involving single-tunnel and double-tunnel (or even triple-tunnel!) fixation sites have been used in an attempt to re-create the “2 (or more) bundles” of the ACL. Transtibial and independent femoral drilling techniques are used in an effort to create a more “anatomic” femoral tunnel placement.
DISCUSSION: Notable regional variability exisits in opioid prescribing patterns for many common orthopaedic procedures. Furthermore, prescriptions were smallest in the region most affected by the opioid epidemic. This information can be used to re-evaluate recommendations, serve as a benchmark for surgeons, and develop institutional and quality improvement guidelines to reduce excess postoperative opioid prescriptions. LEVEL OF EVIDENCE: Level III observational cohort study. PMID: 32568996 [PubMed - as supplied by publisher]
When it comes to meniscal repair, optimizing the local biological environment at the repair site by performing trephination to create bleeding from the extracapsular capillary network, by rasping to abrade the local synovial tissue, or by creating bleeding from the intercondylar notch is recommended. The addition of platelet-rich plasma probably also helps, especially absent the bleeding when meniscal repair is performed concomitantly with anterior cruciate ligament reconstruction. However, pending future research, there is not enough data to recommend platelet-rich plasma augmentation for meniscal repair in all cases.