Evaluation and Management of Osteochondral Lesions of the Talus.

Osteochondral lesions of the talus are common injuries that affect a wide variety of active patients. The majority of these lesions are associated with ankle sprains and fractures though several nontraumatic etiologies have also been recognized. Patients normally present with a history of prior ankle injury and/or instability.

Braking Reaction Time After Right-Knee Anterior Cruciate Ligament Reconstruction: A Comparison of 3 Grafts.

Purpose: To determine when patients recover the ability to safely operate the brakes of an automobile after a right-knee anterior cruciate ligament reconstruction (ACLR).

Methods: A computerized driving simulator was used to determine braking ability after an isolated right-knee ACLR. Thirty healthy volunteers were tested at 1 visit to determine normal mean values, and 27 treatment subjects were tested at 1 week, 3 weeks, and 6 weeks after ACLR.

Does Anteromedial Portal Drilling Improve Footprint Placement in Anterior Cruciate Ligament Reconstruction?

Background: Considerable debate remains over which anterior cruciate ligament (ACL) reconstruction technique can best restore knee stability. Traditionally, femoral tunnel drilling has been done through a previously drilled tibial tunnel; however, potential nonanatomic tunnel placement can produce a vertical graft, which although it would restore sagittal stability, it would not control rotational stability. To address this, some suggest that the femoral tunnel be created independently of the tibial tunnel through the use of an anteromedial (AM) portal, but whether this results in a more anatomic footprint or in stability comparable to that of the intact contralateral knee still remains controversial.

The learning curve associated with anteromedial portal drilling in ACL reconstruction.

Objectives: The objective of the current study was to evaluate the accuracy and precision of femoral and tibial tunnel placement during anterior cruciate ligament reconstruction (ACLR) using independent anteromedial portal (AMP) drilling over a three-year observation period.

Methods: This study was a retrospective review of 161 consecutive primary ACL reconstructions from a single surgeon over his first 36-months in practice. Femoral and tibial tunnel angulation measurements were made on anteroposterior radiographs by a single observer utilizing the assessment method described by Aglietti et al.