Introduction: There are various surgical techniques applied for the treatment of osteochondral lesions of the talus (OLT). The mosaicplasty technique is one of the most commonly used methods for deep lesions. The all-arthroscopic technique with scaffold and autograft bone taken from the tibial plafond is a novel method as an alternative to the mosaicplasty.
View Article and Find Full Text PDFBackground: The aim of the study was to quantify the effect of functional knee bracing on native knee kinematics and the in-situ force in the ACL in response to external loading.
Methods: A robotic testing system was used to apply three external loads from full extension to 60° of flexion to eight fresh frozen human cadaveric knees: 1) a 134 N anterior load, 2) a combined 5-Nm internal rotation +5-Nm valgus torque, and 3) a combined 5-Nm external rotation +5-Nm valgus torque. For native and braced states, kinematics were recorded and the in-situ force in the ACL was determined.
Purpose: To assess the accuracy of answers provided by ChatGPT 4.0 (an advanced language model developed by OpenAI) regarding 25 common patient questions about hip arthroscopy.
Methods: ChatGPT 4.
Acta Orthop Traumatol Turc
April 2024
The exploration of underlying biological risk factors for anterior cruciate ligament (ACL) injury has generated a substantial body of literature describing the role of bony morphology of the knee. Morphological risk factors, such as poor tibiofemoral joint congruity, a narrow femoral intercondylar notch, and an increased posterior tibial slope (PTS), have been implicated in contributing to knee instability and biomechanical abnormalities. Additionally, investigations into sex-specific differences in bony morphology have unveiled distinct risk profiles for males and females.
View Article and Find Full Text PDFPurpose: End-stage ankle arthrosis causes severe pain and limited movement. Tibiotalocalcaneal arthrodesis with arthroscopy-assisted hindfoot nailing can be used to achieve a high union rate and low complication rate. We aimed to examine the early- and mid-term results of patients treated with this technique from various perspectives and to evaluate them by comparing them with the current literature.
View Article and Find Full Text PDFPurpose: To perform a multinational survey and identify patterns in capsular management at the time of hip arthroscopy.
Methods: An anonymous, nonvalidated survey was distributed by the American Orthopaedic Society for Sports Medicine; Arthroscopy Association of North America; European Society of Sports Traumatology, Knee Surgery & Arthroscopy; International Society for Hip Arthroscopy; and Turkish Society of Sports Traumatology, Arthroscopy, and Knee Surgery. The questions were broken down into 6 categories: demographic characteristics, capsulotomy preference, traction stitches, capsular closure, postoperative rehabilitation, and postoperative complications.
Anterior cruciate ligament (ACL) injuries are increasingly common in the adolescent age group. Recent literature has endorsed combining ACL reconstruction with lateral extra-articular procedures to minimize residual rotatory knee instability and reduce the risk of reinjury in this age group. This technique describes a single-bundle combined anatomical ACL reconstruction and lateral extra-articular reinforcement performed with a single iliotibial band autograft.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
December 2023
Purpose: Despite the recent increase in the use of quadriceps tendon (QT) autograft in anterior cruciate ligament reconstruction (ACLR); however, there remains a paucity of literature evaluating the postoperative morphology of the QT. The present study aimed to determine the postoperative morphologic change of the QT at a minimum of 2 years following harvesting during ACLR.
Methods: Patients who underwent ACLR with QT autograft and underwent magnetic resonance imaging (MRI) at a minimum of 2 years following harvesting were retrospectively included in the study.
Background: Knee laxity increases with medial meniscectomy in anterior cruciate ligament (ACL)-reconstructed knees; however, the biomechanical effect of an additional lateral extra-articular tenodesis (LET) is unknown.
Purpose/hypothesis: The purpose of this study was to determine the kinematic effect of a LET in knees that underwent combined ACL reconstruction (ACL-R) and partial medial meniscus posterior horn (MMPH) meniscectomy. It was hypothesized that the addition of LET would reduce laxity in the ACL-reconstructed knee.
Capsule closure during hip arthroscopy is increasingly being shown to optimize outcomes and minimize complications. Although various techniques and suture configurations have been described, closure of the hip capsule remains a technically challenging step for many hip arthroscopists. The purpose of this Technical Note is to summarize capsular management in arthroscopic hip-preservation surgery and to outline a technique of passing capsule sutures under hip traction.
View Article and Find Full Text PDFBackground: Multiple-revision anterior cruciate ligament reconstruction (ACLR) presents several technical challenges, often due to residual hardware, tunnel widening, malposition, or staged surgeries.
Purpose: To compare failure and complication rates between the over-the-top (OTT) and transportal drilling (TD) techniques in patients undergoing surgery for failed revision ACLR.
Study Design: Cohort study; Level of evidence, 3.
Purpose: To perform a systematic review and meta-analysis to investigate the rate of stiffness after multi-ligament knee injury (MLKI) surgery and identify potential risk factors associated with postoperative stiffness.
Methods: This study was conducted in accordance with the 2020 PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Registration was done on the PROSPERO International Prospective Register of Systematic Reviews (CRD42022321849).
Knee Surg Sports Traumatol Arthrosc
October 2023
Purpose: Variations in femoral and tibial bony morphology have been associated with higher clinical grading and increased quantitative tibial translation, but not tibial acceleration, during the pivot shift test following anterior cruciate ligament (ACL) injury. The purpose of this study was to determine the impact of femoral and tibial bony morphology, including a measurement influenced by both parameters (the Lateral Tibiofemoral Articular Distance (LTAD)), on the degree of quantitative tibial acceleration during the pivot shift test and rates of future ACL injury.
Methods: All patients who underwent primary ACL reconstruction from 2014 to 2019 by a senior orthopedic surgeon with available quantitative tibial acceleration data were retrospectively reviewed.
Postoperative patient satisfaction after anterior cruciate ligament reconstruction (ACL-R) is influenced mainly by the degree of pain, the need for reoperation, and functional performance in daily activities and sports. Graft choice has shown to have an influence on postoperative outcomes after ACL-R. While patient reported outcomes measurements do not differ between graft options, evidence shows that normal knee kinematics is not fully restored after ACL-R with an increase in postoperative anterior tibial translation (ATT).
View Article and Find Full Text PDFGraft selection in anterior cruciate ligament (ACL) reconstruction is critical, as it remains one of the most easily adjustable factors affecting graft rupture and reoperation rates. Commonly used autografts, including hamstring tendon, quadriceps tendon and bone-patellar-tendon-bone, are reported to be biomechanically equivalent or superior compared to the native ACL. Despite this, such grafts are unable to perfectly replicate the complex anatomical and histological characteristics of the native ACL.
View Article and Find Full Text PDFSeveral factors contribute to the greater complexity of revision anterior cruciate ligament reconstruction compared with primary anterior cruciate ligament reconstructive surgery. Prior tunnels and hardware may compromise revision tunnel placement and secure fixation. This may necessitate two-stage revision or specific techniques to achieve anatomic revision tunnels.
View Article and Find Full Text PDFGraft failure is a challenging complication following anterior cruciate ligament reconstruction (ACL-R). Among the multiple anatomic and nonanatomic risk factors contributing to ACL-R failure, there is accumulating evidence that a posterior tibial slope of 12° or greater may predispose patients to graft failure of primary and revision ACL-R. In addition, previously malpositioned or widened tunnels, as well as limited autograft options, pose challenges in the setting of revision ACL-R.
View Article and Find Full Text PDFBackground: Soft tissue interposition between a suspensory cortical button and the lateral femoral condyle is the most common cause of postoperative suspensory cortical button migration in patients undergoing anterior cruciate ligament reconstruction (ACLR).
Purpose: To investigate the effects of soft tissue interposition and suspensory cortical button migration after ACLR on functional outcomes and graft ligamentization.
Study Design: Cohort study; Level of evidence, 3.
Background: Surgical treatment is usually required for malignant foot and ankle tumors. In this study, we sought to review factors in treatment that may be associated with morbidity and mortality.
Methods: All malignant foot and ankle tumors at our institution between April 1988 and April 2018 were retrospectively reviewed.
Background: Ramp lesions are encountered in 16% to 24% of all anterior cruciate ligament (ACL) ruptures. However, isolated ramp lesions without a ruptured ACL have also been reported.
Purpose: To evaluate outcomes after type 3 hidden ramp lesions without ACL rupture were treated with all-inside sutures passed through the standard anterior portal.
Objectives: This study aims to investigate the factors that may be associated with surgical site infection and mortality in pelvic resection surgeries.
Patients And Methods: A total of 68 patients (40 males, 28 females; mean age: 43±16.2 years; range, 11 to 70 years) who underwent internal or external hemipelvectomy between January 2010 and January 2020 were retrospectively analyzed.