Bone bruise patterns in knee injuries: where are they found?

Purpose: Bone bruise represents an entity of occult bone lesions that can occur in the knee, causing knee pain and tenderness clinically. The aim of this study was to investigate the incidence and pattern of bone bruising seen in the anterior cruciate ligament (ACL) injury cohort, the non-ACL injury cohort, and between both cohorts.

Methods: We reviewed 710 knee magnetic resonance imagings performed over a 6-month period.

Effect of cryoprotectant incubation time on handling properties of allogeneic tendons prepared for knee ligament reconstruction.

Soft tissue tendon allografts prepared for anterior cruciate ligament reconstruction are becoming increasingly popular; although concerns exist regarding increased long-term laxity and traumatic rupture rates. This qualitative study evaluated the tissue handling properties of human tibialis posterior tendons prepared using a patented process to improve allograft remodeling and ligamentization under differing cryoprotectant incubation times over 60-min rehydration. Tendons that had been incubated for 8 h had smaller diameters than those that were incubated for 2 h (8.

The relationship of the lateral cord of the brachial plexus to the coracoid process during arthroscopic coracoid surgery: a dynamic cadaveric study.

Background: Arthroscopic coracoid decompression is performed for coracoid impingement and has also been advocated for arthroscopic repair of tears of the subscapularis tendon, placing the lateral cord or the musculocutaneous nerve at risk of injury. The dynamic relationship of the lateral cord to the coracoid while the upper limb is in abduction and traction in the shoulder arthroscopy position is not clear.

Purpose: The purpose of this study was to evaluate the dynamic relationship of the lateral cord of the brachial plexus to the coracoid process during varying degrees of upper limb abduction in traction.

Recurrent patellar dislocation: reappraising our approach to surgery.

Introduction: The management of recurrent traumatic patellar dislocation includes surgical realignment. There is no clear distinction whether proximal soft tissue or distal procedures produce superior results. However, distal realignment procedures are commonly associated with greater morbidity.

Return to sports after anterior cruciate ligament reconstruction - a review of patients with minimum 5-year follow-up.

Introduction: It is difficult to counsel the anterior cruciate ligament (ACL) deficient patient considering surgical reconstruction on the likelihood of eventual return to sports as information on this is lacking, especially in the Asian context. We wanted to determine how many of our patients who had ACL surgery returned to their previous levels of sports, 5 years after their surgery. For those that had not returned to their previous levels of sports, we wanted to identify their reasons for not doing so.

Clinical evaluation of arthroscopic-assisted allograft meniscal transplantation.

Introduction: A meniscal deficient knee is at risk of early degenerative osteoarthritis. Allograft meniscal transplantation has been used to treat the meniscus deficiency to alleviate pain symptoms and to delay progression to arthritis. This case series aims to assess the postoperative outcomes of patients who have undergone meniscal allograft transplantation in our hospital.

Anatomic double bundle ACL reconstruction: a literature review.

With the abundance of anatomic double bundle ACL reconstruction techniques that currently exist and limited patient outcome data, one has to ask whether or not they should be used and if so, which one, and what is the learning curve for the average knee surgeon to become competent with the technique that they select? The purpose of this literature review is to summarize existing anatomic double bundle ACL reconstruction surgical and rehabilitation techniques and the clinical and biomechanical study evidence that currently exists. In choosing to perform anatomic double bundle ACL reconstruction we suggest that the knee surgeon should look for evidence of: (1) control of the pivot shift phenomenon, (2) improved transverse plane rotatory knee control during the performance of sports type movements, (3) a decreased likelihood of revision procedures either for ACL reconstruction or for treatment of associated primary or recurrent meniscal injuries, (4) improved patient self-reports of perceived function, satisfaction, and quality of life, and (5) radiographic evidence of a lower incidence and/or magnitude of osteoarthritic changes compared to conventional single bundle ACL reconstruction.

Evaluation of BioCorkscrew and Bioknotless RC suture anchor rotator cuff repair fixation: an in vitro biomechanical study.

This in vitro biomechanical study used cadaveric specimens to compare the rotator cuff repair fixation provided by BioCorkscrew and Bioknotless RC suture anchors. Three cm wide by 1-cm long full-thickness supraspinatus defects were repaired using either two BioCorkscrew suture anchors with combined vertical and horizontal mattress sutures (n = 7) or three Bioknotless RC suture anchors with simple sutures (n = 7). Therefore, the BioCorkscrew suture anchor group had two sutures per anchor (four total sutures), while the Bioknotless RC suture anchor group had one suture per anchor (three total sutures).

Self-reported patient outcomes at a minimum of 5 years after allograft anterior cruciate ligament reconstruction with or without medial meniscus transplantation: an age-, sex-, and activity level-matched comparison in patients aged approximately 50 years.

Purpose: Patient outcomes at a minimum of 5 years after medial meniscus transplantation and primary anterior cruciate ligament (ACL) reconstruction via allograft tissues were compared with those of age-, sex-, and activity level-matched patients who underwent meniscal repair or partial meniscectomy and primary ACL reconstruction via allograft tissues.

Methods: Eight patients (mean age, 51 +/- 5 years; three women and five men) at 5.5 +/- 0.

Bilateral spontaneous rupture of the quadriceps tendon as an initial presentation of alkaptonuria--a case report.

Unilateral rupture of the quadriceps tendon is not uncommon, but bilateral spontaneous quadriceps tendon rupture is a rare occurrence and is usually associated with some underlying predisposing condition. We describe a case of a previously healthy patient who presents with bilateral spontaneous rupture of both quadriceps tendon. Investigations revealed that he had underlying alkaptonuria which was previously undiagnosed.

A simple method of meniscus repair using the arthroscopic outside-in technique.

We describe a simple method of arthroscopic outside-in meniscus repair that is easy to perform using readily available materials. The technique uses a 19-gauge venepuncture needle, a 16-gauge epidural needle, a No. 3 Prolene suture as a lasso loop, and No.

A biomechanical comparison of the FasT-Fix meniscal repair suture system and the RapidLoc device in cadaver meniscus.

Purpose: This biomechanical study compared the fixation characteristics of horizontally or vertically implanted FasT-Fix devices (Smith & Nephew, Endoscopy Division, Andover, MA) consisting of two 5-mm PLLA suture T-bar anchors with a pretied self-sliding knot (No. 0 nonabsorbable, USP, braided polyester suture material) and the RapidLoc device (Mitek Surgical Products, Westwood, MA) consisting of a PLLA T-bar anchor or "backstop," a connecting suture (No. 2 nonbiodegradable Ethibond; Ethicon, Somerville, NJ), and a PLLA grommet, for repairing posterior third lesions in human menisci.

Effect of lesion location on fixation strength of the meniscal viper repair system: an in vitro study using porcine menisci.

Purpose: The Meniscal Viper Repair System (Arthrex, Naples, FL) is a novel suture-based all-inside meniscal repair system. This study was performed to test whether the Meniscal Viper Repair System would provide superior fixation characteristics for vertical longitudinal meniscal lesions located closer to the periphery compared with those located further away from the periphery.

Methods: Vertical longitudinal lesions were created either 1 to 2 mm or 3 to 4 mm away from the periphery of porcine menisci.

Single femoral socket double-bundle anterior cruciate ligament reconstruction using tibialis anterior tendon: description of a new technique.

The native anterior cruciate ligament (ACL) has been shown to consist of 2 functional bundles with independent behavior throughout range of knee motion. Conventional arthroscopic ACL reconstruction techniques selectively recreate the anteromedial bundle of the native ACL only. Numerous studies have reported the failure to restore normal knee kinematics in an ACL-deficient knee using a single-bundle reconstruction.

Biomechanical comparison of the bioabsorbable RetroScrew system, BioScrew XtraLok with stress equalization tensioner, and 35-mm Delta Screws for tibialis anterior graft-tibial tunnel fixation in porcine tibiae.

Background: Achieving effective soft tissue graft-tibial tunnel fixation remains problematic.

Hypothesis: No differences would exist for tibialis anterior graft-tibial tunnel fixation when comparing the RetroScrew System (20-mm retrograde screw, 17-mm antegrade screw), the 35-mm tapered Delta Screw (manual tensioning), and the 35-mm BioScrew XtraLok (applied using an instrumented tensioner).

Study Design: Controlled laboratory study.

Knee dislocations-a retrospective study comparing operative versus closed immobilization treatment outcomes.

Controversies over operative versus closed immobilization of traumatic complex multiple ligamentous knee injury are still debated. The aim of our study is to evaluate the outcome of reconstructive vs non-reconstructive (closed immobilization) treatment outcomes. This is a retrospective review of cases seen at our institution.

Necrotizing fasciitis: clinical presentation, microbiology, and determinants of mortality.

Background: Necrotizing fasciitis is a life-threatening soft-tissue infection primarily involving the superficial fascia. The present report describes the clinical presentation and microbiological characteristics of this condition as well as the determinants of mortality associated with this uncommon surgical emergency.

Methods: The medical records of eighty-nine consecutive patients who had been admitted to our institution for necrotizing fasciitis from January 1997 to August 2002 were reviewed retrospectively.