Anterior cruciate ligament reconstruction (ACLR) using double adjustable fixation gained popularity in the last decade due to its minimally invasive technique. However, suspensory fixation devices could be related to recurrent instability, poor clinical outcomes, and patient dissatisfaction. The present study aims to evaluate the clinical outcomes following ACLR using double adjustable-loop suspensory fixation devices in the demanding population of young patients.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
November 2024
Purpose: The aim of this consensus was to develop evidence- and expert-based patient-focused recommendations on the appropriateness of intra-articular platelet-rich plasma (PRP) injections in different clinical scenarios of patients with knee osteoarthritis (OA).
Methods: The RAND/UCLA Appropriateness Method was used by the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy (ESSKA), as well as the International Cartilage Regeneration and Joint Preservation Society (ICRS) to reach a consensus and produce recommendations for specific patient categories combining best available scientific evidence with the collective judgement of a panel of experts.
Results: Scenarios were defined based on first treatment vs first injective treatment vs second injective treatment, age (<50/50-65/66-80/>80), tibiofemoral vs patellofemoral involvement, OA level (Kellgren-Lawrence/KL 0-I/II-III/IV), and joint effusion (dry knee, minor-mild or major effusion).
Purpose: The aim of this European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) consensus is to provide recommendations based on evidence and expert opinion to improve indications, decision-making and administration-related aspects when using blood-derived orthobiologics (for simplicity indicated as PRP-platelet-rich plasma-with PRP being the most common product) for the management of knee osteoarthritis (OA).
Methods: Leading European expert clinicians and scientists were divided into a steering group, a rating group and a peer review group. The steering group prepared 28 question-statement sets divided into three sections: PRP rationale and indications, PRP preparation and characterisation and PRP protocol.
Gunshot injuries and bullet removal are extremely rare indications for hip arthroscopy. We present the case of a 22-year-old male with a free-floating bullet in the hip joint after a gunshot injury. A thorough imaging investigation was used to demonstrate the exact location of the foreign body.
View Article and Find Full Text PDFPurpose: Mesenchymal stem cells (MSCs) present a valuable treatment option for knee osteoarthritis with promising results. The purpose of the present study was to systematically review the clinical and functional outcomes following mesenchymal stem cell application focusing on early to moderate knee osteoarthritis.
Methods: A systematic search was done using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in Pubmed, Scopus, Web of Science, and Cochrane Library databases.
Objective: This study aimed to assess the clinical and radiographic outcomes of juvenile patients who suffered from stage II or III osteochondritis dissecans (OCD) of the knee and underwent arthroscopic retrograde drilling and internal fixation with bioabsorbable pins.
Design: Medical and radiological records from patients aged 11 to 16 years, who underwent arthroscopic treatment for OCD lesions of the knee in 2 tertiary hospitals, were retrospectively reviewed. The procedure was indicated by persistent pain and by magnetic resonance imaging (MRI).
Purpose: The purpose of the present study was to investigate the mid-term outcomes of a single-stage cell-based procedure in patients with knee focal symptomatic cartilage defects using matrix-induced culture-expanded autologous AD-MSCs. It was hypothesised that the increased number of autologous AD-MSCs after culture expansion is a safe and efficient cartilage repair procedure, which improves overtime chondrogenesis in cartilage lesions METHODS: Twenty-five consecutive patients treated for a symptomatic cartilage defect were prospectively followed for 3 years. The median age of patients was 30.
View Article and Find Full Text PDFThe present study aims to evaluate the efficacy of matrix-induced adipose-derived mesenchymal stem cells (Ad-MSCs) for cartilage repair of focal chondral knee lesions. Twenty patients were initially treated for symptomatic full-thickness chondral defects and then prospectively followed for two years. All patients underwent a single- stage procedure consisting in filling each defect with autologous culture-expanded mesenchymal stem cells embedded in a trimmed-to-fit commercially available biodegradable matrix.
View Article and Find Full Text PDFBackground: In the absence of clear guidelines for facial aesthetic surgery, most surgeons rely on expert intuitive judgement when planning aesthetic and reconstructive surgery. One of the most famous theories regarding "ideal" facial proportions is that of the golden proportion. However, there are conflicting opinions as to whether it can be used to assess facial attractiveness.
View Article and Find Full Text PDFPurpose: Anterior cruciate ligament (ACL) injury is associated with a pathologic gait pattern and increased energy cost during locomotion. ACL reconstruction could improve the gait pattern. Hamstrings tendon (HAM) and bone-patellar tendon-bone (BPTB) grafts are usually used for reconstruction.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
November 2017
Purpose: It is questionable how much of the PCL is really preserved following a complete transverse tibial cut during a cruciate-retaining (CR) total knee arthroplasty (TKA). It is hypothesized that a complete transverse tibial cut jeopardizes the PCL tibial insertion during a common CR TKA. Thus, the aim of the present study was to assess intraoperatively the amount of PCL tibial attachment damage following a standard complete tibial cut technique.
View Article and Find Full Text PDFAim: The morbidity and mortality after a hip fracture in the elderly population are multifactorial. The aim of this study is to determine the long-term impact of specific factors to mortality rate and mobility after a hip fracture in the elderly.
Materials And Methods: Elderly suffering a hip fracture after a low-energy trauma was included in the study, whereas moribund patients with severe comorbid conditions and high-energy trauma were excluded.
Knee Surg Sports Traumatol Arthrosc
May 2017
Purpose: Patients with ACL injury requiring surgical treatment (non-copers) demonstrate altered neuromuscular control and gait pattern compared with those returning to their pre-injury activities without surgery (copers). Pathological gait pattern may increase the energy cost of walking. We compared the energy cost of flat, uphill, and downhill walking between ACL-deficient and healthy individuals and between "copers" and "non-copers".
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
September 2015
Purpose: To investigate the prevalence of lower extremities clinical and radiographic OA in former elite male athletes and referents from the general population and to examine its association with the participants' demographic characteristics.
Methods: Two hundred and eighteen former elite male athletes (soccer, volleyball, martial arts, track and field and basketball players, and skiers) and 181 male controls that reported no systematic athletic activity were examined by means of questionnaire, clinical and radiographic evaluation. Exclusion criteria were age younger than 40 years and a positive history of lower extremity surgery, bone or soft tissue trauma and inflammatory arthropathy.
Hypothesis: The present study aimed to evaluate the variability of the posterolateral corner of the acromion (PCA) position in relation to the glenohumeral joint, in a craniocaudal direction, to assess whether the universal use of a certain distance from that point will always lead to a consistent placement of the posterior arthroscopic portal of the shoulder.
Methods: The study used 140 dried scapulae (36 women and 34 men). Measurements included the glenoid height and the perpendicular distance between the PCA and the most superior point of the glenoid.
Knee Surg Sports Traumatol Arthrosc
August 2014
Purpose: The optimal fixation of the Rotaglide total knee arthroplasty's (TKA) components is controversial. It is hypothesized that the hybrid fixation (cementless femoral component) in a mobile-bearing TKA system might cause increased rate of loosening--especially in the femoral part--and finally failure of the arthroplasty. Consequently, the aim of this study was to compare the survival and revision rates and also the clinical and radiological outcomes of the cemented and hybrid fixation of the Rotaglide TKA.
View Article and Find Full Text PDFSimultaneous rupture of both the patellar tendon and the anterior cruciate ligament is a relatively rare injury. Its diagnosis can easily be missed during the initial examination. Treatment options include immediate repair of the patellar tendon with either simultaneous or delayed reconstruction of the ACL.
View Article and Find Full Text PDFPurpose: To evaluate in vivo the differences in tibial rotation between single- and double-bundle anterior cruciate ligament (ACL)-reconstructed knees under combined loading conditions.
Methods: An 8-camera optoelectronic system and a force plate were used to collect kinematic and kinetic data from 14 patients with double-bundle ACL reconstruction, 14 patients with single-bundle reconstruction, 12 ACL-deficient subjects, and 12 healthy control individuals while performing 2 tasks. The first included walking, 60° pivoting, and stair ascending, and the second included stair descending, 60° pivoting, and walking.
Purpose: To investigate whether anatomic restoration of the anterior cruciate ligament (ACL) functional bundles results in significant reduction in transverse-plane instability compared with the conventional single-bundle technique during a dynamic 60 degrees pivoting maneuver with the supporting knee in extension.
Methods: Using an 8-camera optoelectronic system and a force plate, we examined 10 patients with double-bundle ACL reconstruction, 12 patients with single-bundle reconstruction, 10 ACL-deficient subjects, and 10 healthy control individuals. The 4 groups did not differ in terms of age, body mass index, duration of follow-up, and number of meniscectomies performed.
Total hip replacement (THR) is one of the most successful elective operations currently being performed. However, increased implant wear in the femoral head-acetabulum articulation has been found to limit the long-term survivorship of the procedure. Clinical complications of this wear process include mechanical failure of the polyethylene insert as well as a biologic foreign-body response to wear debris.
View Article and Find Full Text PDFLesions of knee's lateral side are less common than medial injuries. The anatomy of the lateral ligaments and the presence of additional structures (eg, fibula head) can cause diagnostic problems. Isolated dislocation of the proximal tibiofibular joint is unusual; therefore, it may be overlooked in the emergency department.
View Article and Find Full Text PDFThrombotic thrombocytopenic purpura (TTP) or Moschowitz's syndrome is characterized by release of unusually large von Willebrand factor (ULvWF) multimers and a deficiency of vWF metalloprotease. It is a very rare condition, but it causes serious problems. The etiology is still unknown, although surgical stress has been associated with TTP, probably by releasing massive amounts of ULvWF.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
August 2006
We present the case of a patient who sustained simultaneous bilateral posterior dislocation of the shoulder after a possible epileptic fit. The confirmation of the diagnosis was reached only by a computed tomography (CT) scan, after the clinical suspicion. Under general anesthesia, close reduction of both shoulder dislocations was done.
View Article and Find Full Text PDFKnee Surg Sports Traumatol Arthrosc
August 2006
Although an injured medial collateral ligament (MCL) will naturally heal, the quality of healing tissue is inferior to the uninjured MCL tissue. Previous studies have shown promising results of sodium orthovanadate (vanadate) in enhancing the quality of rat skin wounds. This study therefore investigated whether vanadate enhances the quality of the rat healing MCL in terms of the collagen fibril organization and diameter.
View Article and Find Full Text PDFTendinopathy affects millions of people in athletic and occupational settings and is a nemesis for patients and physicians. Mechanical loading is a major causative factor for tendinopathy; however, the exact mechanical loading conditions (magnitude, frequency, duration, loading history, or some combinations) that cause tendinopathy are poorly defined. Exercise animal model studies indicate that repetitive mechanical loading induces inflammatory and degenerative changes in tendons, but the cellular and molecular mechanisms responsible for such changes are not known.
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