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The Ribbon-shaped Femoral Footprint of the Medial Patellofemoral Ligament: Implications for Reconstruction
We describe the ribbon-shaped footprint of the MPFL on the medial femur and the associated difficulty in identifying the origin as a single “point.” Varying isometry and biomechanical functions have been shown to exist within the most proximal and most distal fibers, suggesting the function of the MPFL may not be fully recreated with a tubular graft in a round tunnel. We review the anatomical descriptions of the elongated femoral footprint of the MPFL and describe our surgical technique to recreate this. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Concepts of the Distal Medial Patellar Restraints: Medial Patellotibial Ligament and Medial Patellomeniscal Ligament
The important medial patellar ligamentous restraints to lateral dislocation are the proximal group (the medial quadriceps tendon femoral ligament and the medial patellofemoral ligament) and the distal group [medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML)]. The MPTL patellar insertion is at inferomedial border of patella and tibial insertion is in the anteromedial tibia. The MPML originates in the inferomedial patella, right proximal to the MPTL, inserting in the medial meniscus. On the basis of anatomy and biomechanical studies, the MPTL and MPML are more important in 2 moments during knee ...
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

An Updated Overview of the Anatomy and Function of the Proximal Medial Patellar Restraints (Medial Patellofemoral Ligament and the Medial Quadriceps Tendon Femoral Ligament)
The medial patellofemoral ligament (MPFL) has been widely accepted to function as “the primary static restraint to lateral patellar displacement.” However, current growing evidence suggests that there is a complex of medial patellofemoral/tibial ligaments, both proximal [MPFL, and medial quadriceps tendon femoral ligament (MQTFL)], and distal (medial patellotibial ligament and the medial patellomeniscal ligament) which restrain lateral patellar translation at different degrees of knee flexion. Specifically, the MQTFL has gained popularity over the last decade because of pure soft tissue attachments into the extensor me...
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Treatment of First-time Patellar Dislocations and Evaluation of Risk Factors for Recurrent Patellar Instability
Approximately one-third of skeletally mature patients with primary patellar dislocation will experience recurrent patellar instability over time. Because of the multifactorial combination of features contributing to overall stability of the patellofemoral joint, first-time patella dislocation presents a challenge to the treating physician. A detailed patient history, focused physical examination, and appropriate diagnostic imaging are essential for identifying risk factors for recurrent instability. Individual risk factors include young patient age, patella alta, trochlear dysplasia, and lateralization of the tibial tuberc...
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Foreword
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - November 5, 2019 Category: Sports Medicine Tags: Editorial Source Type: research

The Resilient Athlete: Lessons Learned in the Military
This article explores the concept of resilience, the efforts to build resilience, lessons learned from the military and applications of the resilience concept to surgical and trauma patients. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Blood Flow Restriction Therapy: From Development to Applications
Blood flow restriction (BFR) has been shown to produce beneficial adaptations to skeletal muscle. These adaptations have been documented in the civilian and military populations. BFR therapy may provide patients a safe method to begin strength training at earlier stages of rehabilitation to allow for earlier and more effective return to activity and improved military readiness. The purpose was to review BFR therapy physiology, complications, side effects, standardized treatment algorithms, and long-term patient outcomes. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Perioperative Pain Management and Avoidance of Long-term Opioid Use
The opioid epidemic continues to be a problem in the United States and prescription opioid overdose fatalities continue to rise. Chronic opioid use threatens military readiness and puts service members at risk for medical separation from military service. Orthopedic surgeons commonly prescribe opioid medications for postsurgical patients. Long-term opioid use can be the result of acute, postoperative opioid intake. Overprescribing may increase the risk of long-term opioid use, medication diversion and adverse outcomes. Preoperative administration of opioids dramatically increases the risk of continued use up to 1 year afte...
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Advanced Functional Bracing in Lower Extremity Trauma: Bracing to Improve Function
There are many bracing options for patients with functional limitations of the lower extremity following trauma. The first question that the provider must ask when evaluating a patient with a foot and ankle functional limitation because of weakness or pain is, “what are the patient’s expectations?” One option for the patient who desires to return to a higher level of function is a novel, custom dynamic orthosis (CDO) that, when coupled with an advanced rehabilitation program, has improved outcomes in patients following lower extremity trauma who have plateaued after traditional rehabilitation pathways. Although this ...
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

The Warrior Model for Human Performance Optimization
Special Operations Combat Personnel (SOCP) face significant challenges and occupational demands that put them at significant risk for musculoskeletal injury. Musculoskeletal injury leads to lost-duty days, medical disqualification, and compromises operational readiness and mission success. Optimizing human performance and developing injury prevention strategies can position SOCP for success, but human performance optimization is a complex process that demands the integration of multiple disciplines to address a broad range of capabilities necessary for this success. The Warrior Model for Human Performance Optimization outl...
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

The Warrior Athlete Part 2—Return to Duty in the US Military: Advancing ACL Rehabilitation in the Tactical Athlete
Rehabilitation following an anterior cruciate ligament reconstruction is a crucial component of the healing and recovery process and full return to duty/play in the tactical modern-day warfighter. The burden of anterior cruciate ligament injuries and subsequent loss of readiness in these military warfighters highlights one of the most significant gaps in musculoskeletal injury care today. Emphasis must be placed on early weight-bearing and range of motion (ROM), namely in this athlete population, to best facilitate a timely care and recovery process. Preoperative rehabilitation should commence immediately following the dia...
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Digital Exclusive Source Type: research

Multiligamentous Knee Injuries in the Military Tactical Athlete
We present a synthesis of the available civilian and military literature and provide an evidence-based review with considerations specific to a military population. (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

Combat and Noncombat Musculoskeletal Injuries in the US Military
Musculoskeletal Injuries (MSKI) are exceedingly common in the US Military, resulting in compromised military medical readiness and a substantial burden on both health care and financial resources. Severe combat-related MSKI sustained during nearly 2 decades of conflict in Iraq and Afghanistan have resulted in frequently devastating injuries that challenge acute care capabilities, require extensive rehabilitation, and often result in long-term disability. Non–combat-related MSKI, while often less severe, are far more common than combat-related MSKI and overall cause a substantially greater number of lost duty days and non...
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research

The Warrior Athlete Part 2: Return to Duty in the US Military
No abstract available (Source: Sports Medicine and Arthroscopy Review)
Source: Sports Medicine and Arthroscopy Review - August 1, 2019 Category: Sports Medicine Tags: Editorial Source Type: research

Impact of Adaptive Sports Participation on Quality of Life
The health benefits of regular recreational physical activity are well known in reducing secondary health consequences of a sedentary lifestyle in the general population. However, individuals with physical disabilities participate less frequently in recreational activity compared with those without disabilities. Although evidence on the impact of recreational physical activity on quality of life in this population is in its infancy, regular recreational and sports activity participation has shown to have a positive association with improvements in quality of life, life satisfaction, community reintegration, mood, and emplo...
Source: Sports Medicine and Arthroscopy Review - May 2, 2019 Category: Sports Medicine Tags: Review Articles Source Type: research