Young men undergoing anterior cruciate ligament reconstruction with patellar tendon autograft and anteromedial drilling outperform at 5- to 10-year follow-up in terms of graft stability and activity levels compared to those undergoing reconstruction with hamstring autograft and transtibial drilling.

Objective: To compare 5- to 10-year outcomes of anterior cruciate ligament (ACL) reconstruction in young men performed with bone-patellar tendon bone (BPTB) autograft and anteromedial portal to reconstruction with hamstring autograft and transtibial technique. It was hypothesised that in young adult men, at 5- to 10-year follow-up, superior restoration of knee laxity and activity levels would be demonstrated using BPTB autograft and anteromedial portal technique.

Methods: Ninety-four men who had ACL reconstruction with BPTB autograft and anteromedial portal were eligible for comparison to 106 men who had reconstruction with hamstring autograft and transtibial technique.

Ipsilateral Quadriceps Tendon-Bone ACL Revision Reconstruction to Address Failed Primary Bone-Patellar Tendon-Bone ACL Reconstruction with Persistent Patellar Bone Defect.

Bone-patellar tendon-bone (BPTB) autograft is a popular graft choice for anterior cruciate ligament reconstruction (ACLR) in active young adults. In case of BPTB ACLR failure, the 3 most popular autograft choices for a revision surgery include contralateral BPTB, contralateral or ipsilateral hamstrings autograft, and contralateral or ipsilateral quadriceps tendon autograft. Quadriceps tendon autograft has been gaining increasing popularity in recent years in this respect, but using quadriceps tendon-bone autograft in the setup of a previous use of ipsilateral BPTB autograft deserves special technical considerations, with emphasis on preserving patellar bone integrity.

Proximal Adductor Longus Tendon Repair With a Concomitant Distal Fascial Release for Complete Hip Adductor Tendon Tears: Surgical Technique and Outcomes in 40 Male Athletes.

Background: The optimal treatment for complete avulsions of the proximal adductor longus (AL) is still debatable, and different operative and nonoperative treatment options have been suggested.

Purpose: To report surgical techniques and functional outcomes of a series of athletes who were treated operatively for proximal AL tears.

Study Design: Case series; Level of evidence, 4.

All-Autograft Multiligament Knee Reconstruction of the Posterior Cruciate Ligament, Anterior Cruciate Ligament, and Posterolateral Corner (KD-IIIL).

Multiligament knee reconstruction constitutes a challenging entity. While allograft use gained popularity in this scenario because it can reduce surgery time and the risk of donor-site morbidities, in some places high-quality allografts are not readily available. In addition, allografts are subjected to some disadvantages compared with autografts, including slower biological incorporation and risk of disease transmission.

Distal Chevron Osteotomy vs The Simple, Effective, Rapid, Inexpensive Technique (SERI) for Mild to Moderate Isolated Hallux Valgus: A Randomized Controlled Study.

Background: Hallux valgus is a common foot deformity that leads to functional disability with serious sequelae. Minimally invasive surgery is often used to treat hallux valgus in order to reduce wound complications and improve recovery time. The objective of this study was to compare a Simple, Effective, Rapid, Inexpensive (SERI) technique with a simple Chevron technique in patients with minimum of 1-year follow-up.

Inside-out Repair of Extensive Meniscal Tears Using Posteromedial and Posterolateral Neurovascular Protective Windows.

Three popular repair techniques for preserving the torn meniscus are the all-inside, outside-in, and inside-out techniques. Among these, the inside-out technique has shown low failure rates, and it therefore remains the gold-standard technique for repairing the torn meniscus. For extensive and chronic meniscal tears, proper use of this technique has become fundamental for knee surgeons.

Accuracy measures of 1.5-tesla MRI for the diagnosis of ACL, meniscus and articular knee cartilage damage and characteristics of false negative lesions: a level III prognostic study.

Background: MRI is the most accurate imaging modality for diagnosing knee pathologies. However, there is uncertainty concerning factors predicting false negative MRI, such as meniscal tear patterns as well as patient factors. The aims of this study were to report 1.

Symmetries in Muscle Torque and Landing Kinematics Are Associated With Maintenance of Sports Participation at 5 to 10 Years After ACL Reconstruction in Young Men.

Background: Long-term maintenance of sports participation is important for young men undergoing anterior cruciate ligament (ACL) reconstruction. Identifying biomechanical characteristics in patients who achieve this goal can assist in elaborating rehabilitation programs and in identifying successful recovery, but this has rarely been investigated.

Purpose: To test the association between maintenance of sports participation at 5 to 10 years after ACL reconstruction and measures of force production and landing biomechanics in men.

Combined reconstruction of the medial patellofemoral and medial patellotibial ligaments: outcomes and prognostic factors.

Purpose: To report outcomes after combined medial patellofemoral ligament (MPFL) and medial patellotibial ligament (MPTL) reconstruction and test associations between prognostic factors and clinical outcomes. It was hypothesised that combined MPFL and MPTL reconstruction would result in significant improvement in function, and that outcomes would be associated with age, sex, Beighton score, concomitant articular lesions, and preoperative function.

Methods: All combined reconstructions of MPFL and MPTL were reviewed.

Isokinetic moment curve abnormalities are associated with articular knee lesions.

The aim of this study was to test whether lesions of the medial meniscus (MM) and of the anterior cruciate ligament (ACL) are associated with specific abnormalities of isokinetic moment curves (IMCs). Fifty-four young adults (20 active healthy people, and 34 patients with unilateral knee injuries) were assessed through knee extensor and flexor isokinetic tests at 60°/s. Qualitative IMC analysis was performed using a novel classification system which identified three distinct abnormal shapes.

Cerebrovascular accidents associated with hip fractures: morbidity and mortality-5-year survival.

Background: Hip fractures are associated with increased cerebrovascular accidents (CVAs) in the first postoperative year. Long-term follow-up for CVA and mortality after hip fracture is lacking. The purpose of this study was to identify risk factors for CVA and follow mortality in hip fractures in a cohort with greater than 2 years follow-up.

Thrombophilia-Associated Factors in Patients with Spontaneous Osteonecrosis of the Knee.

Objective: To test whether patients with spontaneous osteonecrosis of the knee (SONK) are characterized by abnormal levels of thrombophilia-associated factors.

Design: Twenty-five patients with SONK were recruited. Inclusion criteria were (1) age >40 years, (2) acute onset knee pain not precipitated by trauma, and (3) MRI findings consistent with SONK.

Operative treatment of pelvic apophyseal avulsions in adolescent and young adult athletes: a follow-up study.

Introduction: Pelvic apophyseal avulsion can limit young athletes' performance for months and may result in permanent disability. Nonoperative treatment is most commonly preferred, while surgical management with reduction and fixation is reserved for selected cases. Our aim was to evaluate outcomes of operative management of pelvic apophyseal avulsions in a series of adolescents and young adult athletes.

The effect of eliminating leg length difference on plantar foot pressure distribution in patients wearing forefoot offloading shoe.

Background And Purpose: Elevated heel construction offloads the forefoot after surgery. However, side-to-side height difference alters limb kinetics, whereas leg-length equalizing-sole at non-operated side may have beneficial effects on foot loading. The purpose of this study was to characterize leg-length equalizing sole effect on bilateral plantar pressures when using heel-lift forefoot-offloading shoe.

Surgical excision of symptomatic mature posttraumatic myositis ossificans: characteristics and outcomes in 32 athletes.

Purpose: The purpose of this study was to report characteristics and outcomes of surgical excision of symptomatic mature posttraumatic myositis ossificans in adult athletes. The hypothesis was that surgical excision of the ossified mass in these circumstances can effectively relief symptoms and result in return to high-level sports with minimal postoperative complications.

Methods: All operations involving excision of posttraumatic heterotopic ossifications performed between 1987 and 2015 were reviewed.

Arthroscopic Excision of Osteoid Osteoma of the Talus.

Osteoid osteoma is a benign tumor that can cause significant pain and disability. Excision of the tumor can be accomplished with open surgery or, as advocated in recent years, with computed tomography (CT)-guided radiofrequency ablation. In this article, a unique arthroscopic approach to excise an osteoid osteoma of the talus is presented.

Factors Associated With Improved Function and Maintenance of Sports Activities at 5 to 10 Years After Autologous Hamstring ACL Reconstruction in Young Men.

Background: There are limited data regarding associated factors of return to sports activities at more than 5 years after anterior cruciate ligament (ACL) reconstruction.

Purpose: To test interrelationships between patient characteristics, concomitant articular lesions, graft laxity, and maintenance of sports activities at 5 to 10 years after ACL reconstruction. It was hypothesized that at 5 to 10 years after the operation in young adult men, maintenance of greater activity level and better knee function would be associated with greater preinjury activity level, younger age at reconstruction, absence of concomitant articular lesions, and minimal graft laxity at follow-up.

Outcomes at a Minimum of 2 Years After Medial Collateral Ligament Reconstruction Using Partial-Thickness Quadriceps Tendon-Bone Autograft.

This study reports outcomes at a minimum of 2 years after a technique using quadriceps tendon-bone autograft for medial collateral ligament reconstruction. This technique effectively restored medial stability in medial collateral ligament-deficient knees. It is particularly valuable when nonirradiated allograft is unavailable or harvesting medial knee restraints (semitendinosus) for medial collateral ligament reconstruction is to be avoided.

The effect of army vest design on the occurrence of stress fractures and overuse injuries in female military recruits.

Introduction: Stress fractures (SFs) occur when microdamage caused by repetitive mechanical load exceeds the biological load-bearing capacity of the bone. The study objective was to test whether a vest specifically designed and manufactured for female recruits, compared with the standard vest used on a regular basis by Border Police recruits, would reduce the incidence of SF in female Border Police recruits. Data based on reports of military personnel show that women are more likely to sustain SFs.

Combined Reconstruction of the Medial Collateral Ligament and Anterior Cruciate Ligament Using Ipsilateral Quadriceps Tendon-Bone and Bone-Patellar Tendon-Bone Autografts.

The exclusive autograft choice for medial collateral ligament (MCL) reconstruction that has been described until today is the semitendinosus tendon. However, this has some potential disadvantages in a knee with combined MCL-anterior cruciate ligament (ACL) injury, including weakening of the hamstring's anterior restraining action in an already ACL-injured knee and nonanatomic distal MCL graft insertion when leaving the semitendinosus insertion intact at the pes anserinus during reconstruction. Moreover, because some surgeons prefer to use the hamstring for autologous ACL reconstruction, the contralateral uninjured knee hamstring needs to be harvested as a graft source for the MCL reconstruction if autografts and not allografts are the surgeons' preference.

[CLINICAL AND ARTHROSCOPIC FINDINGS IN MENISCAL INJURY AND KNEE INSTABILITY: A PROSPECTIVE STUDY].

Introduction: Medical history and physical examination are expected to provide the basic knowledge allowing diagnosis of a disease and thus enabling to plan the course of treatment.

Objective: This study aimed to examine this hypothesis by comparing pre-operative diagnosis of meniscal and anterior cruciate ligament (ACL) injuries to final surgical findings.

Material And Methods: We prospectively compared the pre-surgical diagnosis to the arthroscopic findings in 753 arthroscopic procedures.

[A NOVEL GENDER-SPECIFIC VEST FOR FEMALE INFANTRY RECRUITS DOES NOT REDUCE THE INCIDENCE OF OVERUSE PAIN SYNDROMES: A PROSPECTIVE RANDOMIZED STUDY AMONG 240 RECRUITS].

Introduction: Overuse pain syndromes constitute a troublesome byproduct of military infantry training, particularly in female fighters. These injuries result in lost days of training, pain and discomfort and can affect fitness and fighting abilities. We hypothesized that a gender specific vest would reduce the incidence of overuse pain syndromes in a population of female recruits during basic training.

Extensive Arthroscopic Chondroplasty for Cartilage Hyperplasia of the Femoral Condyle Causing Recurrent Knee Locking in a Patient With Multiple Epiphyseal Dysplasia.

Multiple epiphyseal dysplasia is a genetically heterogeneous group of diseases causing altered enchondral ossification. It may affect the knee, among other joints, with variable clinical manifestations. In this report, we present a case of a young adult patient with multiple epiphyseal dysplasia, presenting recurrent catching and locking of the knee due to hyperplastic irregular cartilage.

Reduced Anterior Cruciate Ligament Vascularization Is Associated With Chondral Knee Lesions.

This study tested the association between periligamentous vascularization of the anterior cruciate ligament (ACL) and the presence of chondral knee lesions via retrospective analysis of prospectively collected data from 702 consecutive knee arthroscopic procedures. In each case, the ACL periligamentous envelope was documented as follows: (1) vascular, where the ACL was covered with blood vessels along its entire length; (2) centrally avascular, where the central third of the ACL was not covered but peripheral vascularized coverage was present; and (3) avascular, where there was no blood vessel coverage of the ACL. Inclusion criteria for the study were as follows: (1) age older than 18 years and (2) normal knee ligament laxity.