Analysis of postoperative complications 5 years after osteosynthesis of patella fractures-a retrospective, multicenter cohort study.

Purpose: The study aims to investigate the influence of patient- and fracture-specific factors on the occurrence of complications after osteosynthesis of patella fractures and to compare knee joint function, activity, and subjective pain levels after a regular postoperative course and after complications in the medium term.

Methods: This retrospective, multicenter cohort study examined patients who received surgery for patella fracture at level 1 trauma centers between 2013 and 2018. Patient demographics and fracture-specific variables were evaluated.

S2k Guideline for Tibial Plateau Fractures - Classification, Diagnosis, and Treatment.

Tibial plateau fractures are mostly complex and surgically demanding joint fractures, which require a comprehensive understanding of the fracture morphology, ligamentous and neurovascular injuries, as well as the diagnostic and therapeutic options for an optimal clinical outcome. Therefore, a standardised and structured approach is required. The success of the treatment of tibial plateau fractures relies on the interdisciplinary cooperation between surgical and conservative physicians in an outpatient and inpatient setting, physical therapists, patients and service providers (health insurance companies, statutory accident insurance, pension providers).

Age-Related Changes in the Microvascular Density of the Human Meniscus.

Background: The microvascular anatomy of the meniscus of the human knee is regarded as a crucial factor in the injury response. Previous studies have investigated the zone-dependent distribution pattern, but no quantitative data exist on vascular density and its age-related changes.

Hypothesis/purpose: The aim of the present study was to histologically analyze the vascular anatomy of the meniscus as a function of age.

Medial collateral ligament reconstruction graft isometry is effected by femoral position more than tibial position.

Purpose: The purpose of this study was to examine the length change patterns of the native medial structures of the knee and determine the effect on graft length change patterns for different tibial and femoral attachment points for previously described medial reconstructions.

Methods: Eight cadaveric knee specimens were prepared by removing the skin and subcutaneous fat. The sartorius fascia was divided to allow clear identification of the medial ligamentous structures.

[Current treatment standard for patella fractures in Germany].

Background: The treatment of patella fractures is technically demanding. Although the radiological results are mostly satisfactory, this often does not correspond to the subjective assessment of the patients. The classical treatment with tension band wiring with K‑wires has several complications.

Bone metabolism is a key factor for clinical outcome of tibial plateau fractures.

Purpose: Given that tibial plateau fractures (TPF) are rare, they may pose a challenge to the treating surgeon due to their variety of complex fracture patterns. Numerous studies have identified potential fracture-specific, surgery-related, and patient-related risk factors for impaired patient outcomes. However, reports on the influence of bone metabolism on functional outcomes are missing.

Trends in arthrodeses and total joint replacements in Foot and Ankle surgery in Germany during the past decade-Back to the fusion?

Background: The goal of this study was to analyze trends in Foot and Ankle surgery in Germany during the past ten years.

Methods: Data of the German Federal Statistical Office from 2008 until 2018 were screened. We focused on the analysis of fusions and total joint replacements.

The Popliteus Bypass provides superior biomechanical properties compared to the Larson technique in the reconstruction of combined posterolateral corner and posterior cruciate ligament injury.

Purpose: This study aimed to compare the biomechanical properties of the popliteus bypass against the Larson technique for the reconstruction of a combined posterolateral corner and posterior cruciate ligament injury.

Methods: In 18 human cadaver knees, the kinematics for 134 N posterior loads, 10 Nm varus loads, and 5 Nm external rotational loads in 0°, 20°, 30°, 60,° and 90° of knee flexion were measured using a robotic and optical tracking system. The (1) posterior cruciate ligament, (2) meniscofibular/-tibial fibers, (3) popliteofibular ligament (PFL), (4) popliteotibial fascicle, (5) popliteus tendon, and (6) lateral collateral ligament were cut, and the measurements were repeated.

Repair With Dynamic Intraligamentary Stabilization Versus Primary Reconstruction of Acute Anterior Cruciate Ligament Tears: 2-Year Results From a Prospective Randomized Study.

Background: Anterior cruciate ligament (ACL) repair has once again become a focus of research because of the development of new techniques.

Purpose/hypothesis: The purpose was to compare the functional results and recurrent instability rates in patients undergoing ACL repair with dynamic intraligamentary stabilization (DIS) versus primary ACL reconstruction (ACLR) for acute isolated ACL tears. The hypothesis was that functional results and knee joint stability after ACL repair with DIS would be comparable with that after ACLR.

[Clinical examination of the knee].

The clinical examination of the knee joint represents a great challenge as well as a great opportunity. In particular, ligamentous injuries are understood better despite their complexity and thus treated in a more differentiated way. A purely radiologically based diagnosis is only possible to a limited extent, especially for chronic injuries.

Soft Tissue Fixation Strategies of Human Quadriceps Tendon Grafts: A Biomechanical Study.

Purpose: To evaluate the effects of different stitching methods and suture diameters on the graft fixation of soft tissue human quadriceps tendon grafts for anterior cruciate ligament (ACL) reconstruction.

Methods: The Krackow locking stitch (K), whipstitch (W), and baseball stitch (B) were combined with either a 2× no. 2 (#2) or a 1× no.

Dynamic Restraints of the Medial Side of the Knee: The Semimembranosus Corner Revisited.

Background: Little is known about the dynamic restraints of the semimembranosus muscle (SM).

Purpose And Hypothesis: The goal of the present study was to elucidate the role of (1) passive and (2) active restraints to medial-side instability and to analyze (3) the corresponding tightening of the posteromedial structures by loading the SM. It was hypothesized that points 1 to 3 will significantly restrain medial knee instability.

Changes in gait pattern and early functional results after ACL repair are comparable to those of ACL reconstruction.

Purpose: Dynamic intraligamentary stabilization (DIS) has been introduced as a new technique to repair the torn anterior cruciate ligament (ACL) and to restore knee joint kinematics after an acute ACL tear. Aim of the present study was to compare the early post-operative activity, restoration of gait pattern and functional results after DIS in comparison with primary ACL reconstruction (ACLR) for acute ACL tears. It was hypothesized that functional results, post-operative activity and changes in gait pattern after DIS are comparable to those after ACLR.

Partial proximal tibia fractures.

Partial tibial plateau fractures may occur as a consequence of either valgus or varus trauma combined with a rotational and axial compression component.High-energy trauma may result in a more complex and multi-fragmented fracture pattern, which occurs predominantly in young people. Conversely, a low-energy mechanism may lead to a pure depression fracture in the older population with weaker bone density.

Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State: A Human Cadaveric Study.

Purpose: To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state.

Methods: Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion.

Anterior Cruciate Ligament Soft Tissue Graft Fixation in the Elderly: Is There a Reason to Use Interference Screws? A Human Cadaver Study.

Purpose: To analyze the ultimate failure load, yield load, stiffness, and cyclic resistance of different anterior cruciate ligament (ACL) soft tissue graft fixation techniques in osteopenic bone.

Methods: In this study, 24 fresh-frozen human cadaveric tibiae (mean age 82.6 years; range 56-96; 6 male and 6 female donors) were used.

Trends and incidences of ligament-surgeries and osteotomies of the knee: an analysis of German inpatient records 2005-2013.

Introduction: In Germany most surgical procedures of the ligaments of the knee and correcting osteotomies of the knees are performed within an inpatient setting. The purpose of this study was to analyze the available data to assess epidemiological trends and incidences in inpatient knee joint surgery.

Materials And Methods: Approximately 154 million anonymized DRG inpatient records were collected by the German Federal Statistical Office between 2005 and 2013.

Should the Ipsilateral Hamstrings Be Used for Anterior Cruciate Ligament Reconstruction in the Case of Medial Collateral Ligament Insufficiency? Biomechanical Investigation Regarding Dynamic Stabilization of the Medial Compartment by the Hamstring Muscles.

Background: Semitendinosus and gracilis muscles are frequently harvested for autologous tendon grafts for cruciate ligament reconstruction. This study investigated the joint-stabilizing effects of these hamstring muscles in cases of insufficiency of the medial collateral ligament (MCL).

Hypotheses: First, both the semitendinosus and gracilis muscles can actively stabilize the joint against valgus moments in the MCL-deficient knee.

Intra-articular tibial plateau fracture characteristics according to the "Ten segment classification".

Background: Currently existing classifications of tibial plateau fractures do not help to guide surgical strategy. Recently, a segment-based mapping of the tibial plateau has been introduced in order to address fractures with a fracture-specific surgical approach. The goal of the present study was to analyze incidence and fracture specifics according to a new 10-segment classification of the tibial plateau.

Biomechanics of the anterior cruciate ligament: Physiology, rupture and reconstruction techniques.

The influences and mechanisms of the physiology, rupture and reconstruction of the anterior cruciate ligament (ACL) on kinematics and clinical outcomes have been investigated in many biomechanical and clinical studies over the last several decades. The knee is a complex joint with shifting contact points, pressures and axes that are affected when a ligament is injured. The ACL, as one of the intra-articular ligaments, has a strong influence on the resulting kinematics.

Biomechanical Properties of Different Fixation Techniques for Posterior Cruciate Ligament Avulsion Fractures.

Purpose: To analyze the ultimate failure load, yield load, stiffness, and cyclic elongation of 4 different fixation techniques for posterior cruciate ligament avulsion fractures under cyclic loading and load-to-failure conditions.

Methods: In 40 porcine knees, a standardized bony avulsion of the posterior cruciate ligament was generated. The osseous avulsion was fixed by the following techniques through an open approach: (1) direct anterograde screw fixation (3.

Conventional over-the-top-aiming devices with short offset fail to hit the center of the human femoral ACL footprint in medial portal technique, whereas medial-portal-aiming devices with larger offset hit the center reliably.

Introduction: Aim of this study was to investigate the accuracy of a conventional over-the-top-guide (OTG) with a typically short offset to hit the center of the native femoral ACL footprint through the anteromedial portal in comparison to a specific medial-portal-aimer (MPA) with larger offset.

Materials And Methods: In 20 matched human cadaveric knees, insertion sites of the ACL were marked in medial arthrotomy. An OTG with an offset of 5.

Comparison of Knee Kinematics After Single-Bundle Anterior Cruciate Ligament Reconstruction via the Medial Portal Technique With a Central Femoral Tunnel and an Eccentric Femoral Tunnel and After Anatomic Double-Bundle Reconstruction: A Human Cadaveric Study.

Background: Anatomic femoral tunnel placement in anterior cruciate ligament (ACL) reconstruction is considered to be a key to good primary stability of the knee. There is still no consensus on whether a centrally placed single bundle in the anatomical femoral footprint can compare with anatomic double-bundle (DB) reconstruction.

Purpose/hypothesis: The purpose of this study was to determine knee kinematics after single-bundle ACL reconstruction via the medial portal technique using 2 different femoral tunnel positions and to compare results with those of the anatomic DB technique.

Knee joint kinematics after dynamic intraligamentary stabilization: cadaveric study on a novel anterior cruciate ligament repair technique.

Purpose: Dynamic intraligamentary stabilization (DIS) has been introduced for the repair of acute anterior cruciate ligament (ACL) tears as an alternative to delayed reconstruction. The aim of the present study was to compare knee joint kinematics after DIS to those of the ACL-intact and ACL-deficient knee under simulated Lachman/KT-1000 and pivot-shift tests. We hypothesized that DIS provides knee joint kinematics equivalent to an intact ACL.

MPFL reconstruction using a quadriceps tendon graft: part 1: biomechanical properties of quadriceps tendon MPFL reconstruction in comparison to the Intact MPFL. A human cadaveric study.

Background: The aim of this study was to analyze the structural properties of the original MPFL and to compare it to a MPFL-reconstruction-technique using a strip of quadriceps tendon.

Methods: In 13 human cadaver knees the MPFLs were dissected protecting their insertion at the patellar border. The MPFL was loaded to failure after preconditioning with 10 cycles in a uniaxial testing machine evaluating stiffness, yield load and maximum load to failure.