Publications by authors named "Alan Getgood"

With an estimated incidence of 0.02% to 0.2%, multiligamentous knee injuries are rare, often devastating injuries that can occur with concomitant vascular or neurologic involvement.

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Osteotomies around the knee have a variety of indications, including pain reduction, functional improvement, knee joint stabilization, and articular cartilage preservation. Thorough preoperative planning is essential, including a determination of the precise location of any deformity (proximal tibia, distal femur, or both). High tibial osteotomies and distal femoral osteotomies can be performed in isolation, or jointly in the form of a double-level osteotomy, for correction of coronal and/or sagittal deformity of the knee.

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Purpose: Medial opening wedge high tibial osteotomy is a surgical procedure intended to relieve the symptoms of osteoarthritis in the medial compartment of the knee by addressing malalignment within the structures of the knee. In previous studies, the osteotomy cut and wedge opening in a Medial opening wedge high tibial osteotomy finite element model has been represented using either one of two techniques, which we define herein as wedge opening and wedge removal approaches. The purpose of this study is to determine whether the wedge removal for a medial opening wedge high tibial osteotomy finite element modelling study predicts accurate stresses and strains in the plate, screw, and throughout the proximal tibia, in comparison to the wedge opening.

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Adjustable Loop Fixation devices (ALD) were introduced to allow tensioning and re-tensioning while increasing flexibility of graft length in the bone tunnel. ALDs have shown comparable clinical and biomechanical results when used for anterior cruciate ligament reconstructions. We routinely use ALDs in multi-ligament knee reconstructions.

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Article Synopsis
  • The study aims to assess how members of the ACL study group are incorporating lateral extra-articular procedures (LEAPs) in ACL reconstruction surgeries over recent years.
  • A survey shared during biennial meetings from 2016 to 2023 revealed an increase in the use of LEAP techniques, with surgeons preferring methods involving iliotibial band (ITB) autograft.
  • The findings indicate that LEAPs, particularly the modified Lemaire technique, are gaining popularity among surgeons, correlating with clinical evidence that suggests better outcomes when these procedures are used alongside traditional ACL reconstruction.
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Article Synopsis
  • The KNEES-ACL is a 41-item patient-reported outcome measure created for individuals with ACL deficiencies and post-reconstruction, proving more effective than other similar measures in clinical studies.
  • The study aimed to translate and adapt this measure from Danish to North American English to make it more accessible.
  • The translation involved a bilingual panel and focus groups to ensure wording fit everyday language, followed by cognitive interviews with ACL injury patients to refine the content to be relevant and understandable.
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Background: Meniscal repair has been associated with long-term benefit in patients compared with meniscectomy. As a generalization, meniscal repair in older patients is less likely to be successful, leading to reduced adoption of meniscal repair compared with younger patients.

Purpose: To establish the clinical performance of meniscal repair in "older" patients (age, ≥40 years) and compare it with performance in "younger" patients (age, <40 years).

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Introduction: Pain and disability after meniscectomy can be a substantial lifelong problem. There are few treatment options, especially for young people. Non-surgical management (rehabilitation) is an option but increasingly surgeons are performing meniscal allograft transplants (MATs) for these individuals.

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Background: New techniques have been proposed to better address anteromedial rotatory instability in a medial collateral ligament (MCL)-injured knee that require an extra graft and more surgical implants, which might not be feasible in every clinical setting.

Purpose: To investigate if improved resistance to anteromedial rotatory instability can be achieved by using a single-graft, double-bundle (DB) MCL reconstruction with a proximal fixation more anteriorly on the tibia, in comparison with the gold standard single-bundle (SB) MCL reconstruction.

Study Design: Controlled laboratory study.

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Background: Injuries to the deep medial collateral ligament (dMCL) and partial superficial MCL (psMCL) can cause anteromedial rotatory instability; however, the contribution of each these injuries in restraining anteromedial rotatory instability and the effect on the anterior cruciate ligament (ACL) load remain unknown.

Purpose: To investigate the contributions of the different MCL structures in restraining tibiofemoral motion and to evaluate the load through the ACL after MCL injury, especially after combined dMCL/psMCL injury.

Study Design: Controlled laboratory study.

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Precision anterior cruciate ligament reconstruction (ACLR) refers to the individualized approach to prerehabilitation, surgery (including anatomy, bony morphology, and repair/reconstruction of concomitant injuries), postrehabilitation, and functional recovery. This individualized approach is poised to revolutionize orthopedic sports medicine, aiming to improve patient outcomes. The purpose of this article is to provide a summary of precision ACLR, from the time of diagnosis to the time of return to play, with additional insight into the future of ACLR.

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The Stability Study was a multicenter, pragmatic, parallel groups, randomized clinical trial comparing hamstring tendon autograft anterior cruciate ligament reconstruction with or without the addition of lateral extra-articular tenodesis in young patients at high risk of graft failure. Having recruited 618 patients with a 5% loss to follow up, we were able to demonstrate a clinically and statistically significant reduction in clinical failure and graft rupture at 2 years postoperative. No differences in patient-reported outcomes (PROs) were demonstrated between groups; however, patients who experienced an adverse event had significantly worse PROs than those who did not.

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Background: The addition of an iliotibial band-based lateral extra-articular tenodesis (LET) to anterior cruciate ligament (ACL) reconstruction (ACLR) has been shown to reduce failure rates. However, there are concerns as to the potential overconstraint of tibiofemoral kinematics that may increase the risk of cartilage degradation. To date, no clinical study has investigated the effect of LET on patellofemoral joint articular cartilage health.

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Background: Injuries to the medial collateral ligament (MCL), specifically the deep MCL (dMCL) and superficial MCL (sMCL), are both reported to be factors in anteromedial rotatory instability (AMRI); however, a partial sMCL (psMCL) injury is often present, the effect of which on AMRI is unknown.

Purpose: To investigate the effect of a dMCL injury with or without a psMCL injury on knee joint laxity.

Study Design: Controlled laboratory study.

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Objectives: To understand the factors influencing young athletes' perceptions of quality of life (QOL) following an anterior cruciate ligament (ACL) rupture, prior to reconstructive surgery.

Design: Qualitative descriptive study using semi-structured interviews and thematic analysis of data.

Setting: Tertiary sports medicine clinic with patients recruited from the practices of three specialist orthopaedic surgeons.

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Understanding the biomechanical impact of injuries and reconstruction of the anterior cruciate ligament (ACL) is vital for improving surgical treatments that restore normal knee function. The purpose of this study was to develop a technique that enables parametric analysis of the effect of the ACL reconstruction (ACLR) in cadaver knees, by replacing its contributions with that of a specimen-specific virtual ACLR that can be enabled, disabled, or modified. Twelve ACLR reconstructed knees were mounted onto a motion simulator.

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A variety of total knee arthroplasty (TKA) designs offer increased congruency bearing options, primarily to compensate for a loss of posterior cruciate ligament (PCL) function. However, their efficacy in providing sufficient stability under different circumstances requires further investigation. The preclinical testing of prosthesis components on joint motion simulators is useful for quantifying how design changes affect joint stability.

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Purpose: To provide an update on the incidence and extent of graft extrusion after meniscal allograft transplantation (MAT) and to systematically review the literature to identify whether the type of root fixation or additional surgical techniques may reduce the risk of graft extrusion development.

Methods: A systematic search, in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, was conducted using the MEDLINE database, EMBASE database, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials (CENTRAL) database. Patients undergoing medial meniscal allograft transplantation (MMAT) or lateral meniscal allograft transplantation (LMAT) were included.

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Article Synopsis
  • Osteoarthritis is increasingly affecting people globally, with no current treatments available that modify the disease, highlighting the need for preventive measures, especially after knee injuries, which are linked to post-traumatic osteoarthritis (PTOA).
  • A workshop held at the 2023 Osteoarthritis Research Society International Congress focused on improving trial designs for preventing PTOA, discussing critical aspects like target populations, treatment methods, and outcomes beyond just pain.
  • The workshop identified opportunities for testing prevention strategies and emphasized collaborating on outcomes that matter to patients, such as knee function and overall symptoms, to make future PTOA prevention trials more effective and relevant.
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Background: Concerns have arisen that anterior cruciate ligament reconstruction (ACLR) with lateral extra-articular tenodesis (LET) may accelerate the development of posttraumatic osteoarthritis in the lateral compartment of the knee.

Purpose/hypothesis: The purpose of this study was to evaluate whether the augmentation of ACLR with LET affects the quality of lateral compartment articular cartilage on magnetic resonance imaging (MRI) at 2 years postoperatively. We hypothesized that there would be no difference in T1rho and T2 relaxation times when comparing ACLR alone with ACLR + LET.

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Objectives: Patellofemoral instability (PFI) has multiple predisposing anatomic factors, including ligamentous hyperlaxity, coronal and axial malalignment, patella alta, trochlea dysplasia, excessive lateral patellar tilt, and excessive lateral Q vector. Yet, few studies have analyzed surgical thresholds for performing axial alignment corrective osteotomies in the treatment of PFI and patella maltracking. The objective of this systematic literature review was to determine if there is a threshold for axial plane alignment that triggers surgical correction for the treatment of patellar instability in the published literature.

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Purpose: To compare return-to-sport (RTS) rates, graft failure rates, and clinical outcomes in patients who underwent revision anterior cruciate ligament reconstruction (R-ACLR) with additional lateral extra-articular tenodesis (LET) versus isolated R-ACLR.

Methods: A retrospective review of the medical records of patients who underwent R-ACLR with or without a modified Lemaire LET procedure was performed. Seventy-four patients with at least 2 years of follow-up who had high-grade positive pivot-shift test findings were included.

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The development of angular stable locking late fixation in realignment osteotomy has resulted in the ability to be more aggressive with weight bearing and rehabilitation after high tibial osteotomy. One of the downsides of some of these plate fixators is the degree of soft-tissue irritation and discomfort that can be experienced by many patients, resulting in the need for hardware removal. Studies have shown greater than 50% of patients requiring hardware removal with no resulting loss of correction, although there may be cultural reasons for the higher number, not solely attributable to the symptom profile.

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Purpose: A machine learning-based anterior cruciate ligament (ACL) revision prediction model has been developed using Norwegian Knee Ligament Register (NKLR) data, but lacks external validation outside Scandinavia. This study aimed to assess the external validity of the NKLR model (https://swastvedt.shinyapps.

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