Blood Flow Restriction Training Can Improve Peak Torque Strength in Chronic Atrophic Postoperative Quadriceps and Hamstrings Muscles.

Purpose: To report a prospective study of patients who underwent blood flow restriction training (BFRT) for marked quadriceps or hamstring muscle deficits after failure to respond to traditional rehabilitation after knee surgery.

Methods: The BFRT protocol consisted of 4 low resistance exercises (30% of 1 repetition maximum): leg press, knee extension, mini-squats, and hamstring curls with 60% to 80% limb arterial occlusion pressure. Knee peak isometric muscle torque (60° flexion) was measured on an isokinetic dynamometer.

Generalized Joint Laxity Is Associated With Increased Failure Rates of Primary Anterior Cruciate Ligament Reconstructions: A Systematic Review.

Purpose: To investigate patients with generalized joint laxity (GJL) after primary anterior cruciate ligament reconstruction (ACLR) as to the risk of ACLR failure, graft selection success rates, and overall clinical outcomes.

Methods: A systematic review of the PubMed and EMBASE databases was performed to identify studies published from the inception of the databases through February 4, 2020. The inclusion criteria were original studies written in English involving outcomes of patients with GJL who had undergone primary ACLR.

One in 5 Athletes Sustain Reinjury Upon Return to High-Risk Sports After ACL Reconstruction: A Systematic Review in 1239 Athletes Younger Than 20 Years.

Context: Anterior cruciate ligament (ACL) reconstruction (ACLR) is frequently performed in patients younger than 20 years whose goal is to return to sport (RTS). Varying reinjury rates have been reported, and the factors responsible are unclear. Studies differ with regard to age, graft type, surgical techniques, postoperative rehabilitation, RTS guidelines, and methods used to determine ACL failures.

Blood Flow-Restricted Training for Lower Extremity Muscle Weakness due to Knee Pathology: A Systematic Review.

Context:: Blood flow-restricted training (BFRT) has been suggested to treat lower extremity muscle weakness. The efficacy of BFRT for muscle problems related to knee pathology is unclear.

Objective:: To determine whether BFRT (1) improves muscle strength and cross-sectional area (CSA) for chronic knee-related lower extremity atrophy and (2) prevents muscle atrophy after knee surgery.

Low-impact sports activities are feasible after meniscus transplantation: a systematic review.

Purpose: To determine sports activities achieved after meniscus transplantation and if associations exist between sports activity levels and transplant failure or progression of tibiofemoral osteoarthritis (OA).

Methods: A systematic search was performed using PubMed and Cochrane online databases. Inclusionary criteria were English language, clinical trials published from 1996 through May 2017, minimum 2 years of follow-up, and sports activity data reported.

Effect of Fatigue Protocols on Lower Limb Neuromuscular Function and Implications for Anterior Cruciate Ligament Injury Prevention Training: A Systematic Review.

Background: Approximately two-thirds of anterior cruciate ligament (ACL) tears are sustained during noncontact situations when an athlete is cutting, pivoting, decelerating, or landing from a jump. Some investigators have postulated that fatigue may result in deleterious alterations in lower limb biomechanics during these activities that could increase the risk of noncontact ACL injuries. However, prior studies have noted a wide variation in fatigue protocols, athletic tasks studied, and effects of fatigue on lower limb kinetics and kinematics.

Aerobic Physical Fitness and Recreational Sports Participation After Total Knee Arthroplasty.

Context: Total knee arthroplasty (TKA) is routinely performed in younger patients who desire to be active in fitness and recreational sports. The activities patients can participate in without symptoms and the level of aerobic fitness routinely maintained are important to investigate.

Objective: To determine physical activity (PA) and recreational sports resumed after primary TKA, symptoms or limitations with these activities, and the effect of postoperative rehabilitation on achieving fitness and sports goals.

Long-term Survivorship and Function of Meniscus Transplantation.

Background: Clinical outcomes and survivorship of meniscus transplants remain unclear, especially when magnetic resonance imaging (MRI) and weightbearing radiographic findings are included as endpoints. Many studies calculate survivorship based only on subsequent operative procedures.

Purpose: We prospectively determined long-term survivorship and functional outcomes of 72 consecutive meniscus transplants.

Meniscal Transplantation in Symptomatic Patients Under Fifty Years of Age: Survivorship Analysis.

Background: The purpose of this study was to prospectively evaluate the long-term results and survivorship of meniscal transplantation in a consecutive series of patients.

Methods: Forty cryopreserved menisci were implanted into thirty-eight patients. Survival end points were transplant removal, revision, or tibiofemoral compartment pain with daily activities.

A systematic review of the incidence and clinical significance of postoperative meniscus transplant extrusion.

Purpose: To determine the incidence and clinical significance of postoperative meniscus transplant extrusion.

Methods: A systematic search was performed using PubMed and Cochrane online databases. Inclusionary criteria were English language, clinical trials of meniscus transplantation published from 1984 to 2014, and meniscus extrusion measured on magnetic resonance imaging (MRI).

Neuromuscular retraining intervention programs: do they reduce noncontact anterior cruciate ligament injury rates in adolescent female athletes?

Purpose: The purpose of this study was to identify neuromuscular training intervention programs that significantly reduced the incidence of noncontact anterior cruciate ligament (ACL) injury rates in female adolescent athletes.

Methods: A systematic search of PubMed was conducted to determine the outcome of ACL neuromuscular retraining programs in a specific population. The inclusion criteria were English language, published from 1994-2013, original clinical trials, all evidence levels, female athletes aged 19 years or younger, and noncontact ACL injury incidence rates determined by athlete-exposures.

Clinical healing rates of meniscus repairs of tears in the central-third (red-white) zone.

Purpose: To determine the clinical healing rate of repairs of meniscus tears that extend into the central one-third region and the factors that affect the outcome.

Methods: A systematic search of PubMed was conducted to determine the outcome of meniscus repairs in the red-white (R/W) zone. Inclusion criteria were as follows: English language, clinical trials published from 1996 to 2013, R/W tears analyzed separately from tears in other zones, arthroscopic suture-based repairs, and all evidence levels.

Advanced patellofemoral cartilage lesions in patients younger than 50 years of age: is there an ideal operative option?

Purpose: The purpose of this review was to determine if there is an ideal operation for large symptomatic articular cartilage lesions on the undersurface of the patella in young patients.

Methods: A systematic search of PubMed was conducted to determine the outcome of operations performed for large patellar lesions in young patients. Inclusionary criteria were English language, original clinical trials published from 1992 to 2012, patellar lesions 4 cm(2) or larger, mean patient age 50 years or younger, and all evidence levels.

Anterior cruciate ligament injury prevention training in female athletes: a systematic review of injury reduction and results of athletic performance tests.

Context: Many anterior cruciate ligament (ACL) injury prevention training programs have been published, but few have assessed the effects of training on both ACL injury rates and athletic performance tests.

Objective: To determine if ACL injury prevention programs have a positive influence on both injury rates and athletic performance tests in female athletes.

Data Sources: In August 2011, a search was conducted (1995-August 2011) of the PubMed, Science Direct, and CINAHL databases.

The development of postoperative knee chondrolysis after intra-articular pain pump infusion of an anesthetic medication: a series of twenty-one cases.

Background: Postoperative chondrolysis in the knee joint caused by continuous intra-articular pain pumps infusing bupivacaine is a serious complication that severely affects function. We report the clinical course of a series of twenty-one patients who were referred to our clinic with this complication.

Methods: A physical examination and a review of medical records were conducted.

A training program to improve neuromuscular and performance indices in female high school soccer players.

The purpose of this study was to determine if a sports-specific anterior cruciate ligament injury prevention training program could improve neuromuscular and performance indices in female high school soccer players. We combined components from a published knee ligament intervention program for jump and strength training with other exercises and drills to improve speed, agility, overall strength, and aerobic fitness. We hypothesized that this program would significantly improve neuromuscular and athletic performance indices in high school female soccer players.

A training program to improve neuromuscular and performance indices in female high school basketball players.

The purpose of this study was to determine if a sports-specific training program could improve neuromuscular and performance indices in female high school basketball players. We combined components from a published anterior cruciate ligament injury prevention program for jump and strength training with other exercises and drills to improve speed, agility, overall strength, and aerobic conditioning. We hypothesized that this sports-specific training program would lead to significant improvements in neuromuscular and performance indices in high school female basketball players.

Factors used to determine return to unrestricted sports activities after anterior cruciate ligament reconstruction.

Purpose: Anterior cruciate ligament (ACL) reconstruction is commonly performed in athletes, with the goal of return to sports activities. Unfortunately, this operation may fail, and the rates of either reinjuring an ACL-reconstructed knee or sustaining an ACL rupture to the contralateral knee range from 3% to 49%. One problem that exists is a lack of information and consensus regarding the appropriate criteria for releasing patients to unrestricted sports activities postoperatively.

Treatment of meniscus tears during anterior cruciate ligament reconstruction.

Purpose: To define the incidence of meniscectomy, meniscus repair, and meniscus tears left in situ during anterior cruciate ligament (ACL) reconstruction.

Methods: A systematic search of PubMed and 7 sports medicine journal databases was performed to determine the treatment of meniscus tears during ACL reconstruction. Inclusion criteria were English language, publication in the last 10 years, clinical trials, all evidence levels, and skeletally mature or immature knees.

Objective criteria for return to athletics after anterior cruciate ligament reconstruction and subsequent reinjury rates: a systematic review.

Objective: To review anterior cruciate ligament (ACL) clinical studies to assess the objective functional criteria used to determine when patients can return to athletics postoperatively, and to determine the rates of reinjury to either knee when these criteria are applied.

Methods: A literature search was conducted using the Medline database. The inclusionary criteria were the English language, publication between April 2001 and April 2011, original clinical trials, all levels of evidence, primary ACL reconstruction, skeletal maturity, minimum 2 years of follow-up, and ≥1 objective test used to allow release to sports activities.

Meniscus repair and transplantation: a comprehensive update.

Preservation of meniscal tissue is paramount for long-term joint function, especially in younger patients who are athletically active. Many studies have reported encouraging results following repair of meniscus tears for both simple longitudinal tears located in the periphery and complex multiplanar tears that extend into the central third avascular region. This operation is usually indicated in active patients who have tibiofemoral joint line pain and are less than 50 years of age.

A training program to improve neuromuscular indices in female high school volleyball players.

The purpose of this study was to determine if a sports-specific training program could improve neuromuscular indices in female high school volleyball players. We combined components from a previously published knee ligament injury prevention intervention program for jump and strength training with additional exercises and drills to improve speed, agility, overall strength, and aerobic conditioning. We hypothesized that this sports-specific training program would lead to significant improvements in neuromuscular indices in high school female volleyball players.

Anterior cruciate ligament graft placement recommendations and bone-patellar tendon-bone graft indications to restore knee stability.

The anterior cruciate ligament (ACL) resists the combined abnormal motions of anterior tibial translation and internal tibial rotation that occur in the pivot-shift phenomenon. The placement of a single ACL graft high and proximal at the femoral attachment and posterior at the tibial attachment results in a vertical graft orientation. This graft position has a limited ability to provide rotational stability.

Repair of complex and avascular meniscal tears and meniscal transplantation.

A functional meniscus is critical to the long-term health of the knee joint. The repair of meniscal tears that extend into the central avascular region requires understanding the appropriate indications, contraindications, surgical techniques, and postoperative rehabilitation protocols. An inside-out repair technique using multiple vertical divergent sutures with an accessory posteromedial or posterolateral incision is recommended for optimal stability.