Intra-articular migration of tibial suture button in pediatric full epiphyseal anterior cruciate ligament reconstruction. A case report.

We report a case of a 12-years-old boy that underwent anterior cruciate ligament (ACL) reconstruction and lateral meniscus repair. The all-epiphyseal, all-inside technique, with quadriceps tendon autograft and adjustable suspensory button fixation was utilized due to the open physes. Intraoperative fluoroscopy confirmed optimal position of the buttons, while arthroscopic evaluation of the graft showed proper tension, with full range of motion and knee stability.

Percutaneous Intramedullary Application of Stem Cells for Fifth Metatarsal Fractures Treated With a Cannulated Screw.

Non-union and refracture of fifth metatarsal fractures are common and devastating complications in the athletic population. Stem cell application at the fracture site, for biologic enhancement, is utilized to address this challenge. We present a simple technique to approach both the endosteum and the periosteum percutaneously, under a local anesthetic, in cases of cannulated screw intramedullary fixation.

Hypertrophied medial parapatellar plica: a case of a medial plica anatomical variation with insertion to the inter-meniscal ligament in an adolescent athlete treated arthroscopically.

Purpose: The present study aims to report the arthroscopic, radiological and clinical appearance of a rare anatomical variation of a hypertrophied medial parapatellar plica with its response to arthroscopic treatment.

Case Presentation: A 14-year-old female handball athlete presented with a history of left knee injury during her participation in a handball training session and subsequent locked knee at 20º flexion. Tenderness was located at the medial joint line.

Gross Measurement of Intraarticular Graft Length in All-Inside Anterior Cruciate Ligament Reconstruction.

Intra articular length (IAL) of the graft has not been measured yet in anatomic, single bundle, anterior cruciate ligament (ACL) reconstruction. Especially in the all-inside ACL reconstruction technique, the IAL of the graft is of great importance due to the philosophy of the technique and the risk of graft "bottoming out". We present a simple arthroscopic measurement of the IAL of the ACL graft in anatomic, single bundle ACL reconstruction, that will allow optimal application of the all-inside technique.

ACL Reconstruction and Modified Lemaire Tenodesis Utilizing Common Suspensory Femoral Fixation.

Persistent rotatory instability after anterior cruciate ligament (ACL) reconstruction has been well studied and recognized as the cause of unsatisfactory clinical results. Various anterolateral techniques have been described as an adjunct to the ACL reconstruction to improve clinical outcomes. Modified deep Lemaire lateral extra-articular tenodesis has been tested both biomechanically and clinically and proved an efficient solution in controlling tibia internal rotation, when performed in conjunction with ACL reconstruction.

From Three-Dimensional (3D)- to 6D-Printing Technology in Orthopedics: Science Fiction or Scientific Reality?

Over the past three decades, additive manufacturing has changed from an innovative technology to an increasingly accessible tool in all aspects of different medical practices, including orthopedics. Although 3D-printing technology offers a relatively inexpensive, rapid and less risky route of manufacturing, it is still quite limited for the fabrication of more complex objects. Over the last few years, stable 3D-printed objects have been converted to smart objects or implants using novel 4D-printing systems.

Three-Dimensional-Printed Scaffolds for Meniscus Tissue Engineering: Opportunity for the Future in the Orthopaedic World.

The meniscus is a critical component of a healthy knee joint. It is a complex and vital fibrocartilaginous tissue that maintains appropriate biomechanics. Injuries of the meniscus, particularly in the inner region, rarely heal and usually progress into structural breakdown, followed by meniscus deterioration and initiation of osteoarthritis.

Isolated Popliteus Tendon Avulsion: Fully Arthroscopic Repair with Suture Anchor: A Case Report.

Case: Isolated popliteus tendon avulsion is an extremely rare injury with no consensus in the literature, regarding the therapeutic approach. In our case, the patient presented with rotational instability of the knee, and he was treated surgically. A fully arthroscopic technique with suture anchors was used, and this is the first report of such a repair in the literature.

The role of hip arthroscopy in the management of osteonecrosis.

Hip arthroscopy has emerged as a diagnostic and therapeutic tool in the management of osteonecrosis (ON) of the femoral head. Direct visualization of the joint, aids the staging of the disease, while mechanical symptoms and pain can be alleviated by addressing the often coexisting intra-articular pathology (labral tears, chondral delamination, loose bodies and synovitis) thereby improving the clinical outcome in some patients. The article explores the role and possible value of hip arthroscopy as a surgical technique in the treatment of hip ON.

Adequacy of semitendinosus tendon alone for anterior cruciate ligament reconstruction graft and prediction of hamstring graft size by evaluating simple anthropometric parameters.

Introduction: Preoperative identification of patients with inadequate hamstring grafts for anterior cruciate ligament reconstruction is still a subject of interest.

Purpose: The purpose of this study was to determine whether the semitendinosus tendon length is adequate for four-strand graft harvested by common technique (without bone plug) and whether there is correlation of gracilis and semitendinosus tendon grafts length and diameter of quadrupled graft with anthropometric parameters.

Materials And Methods: In this retrospective study, 61 patients (45 males, 16 females) undergoing ACL reconstruction using four-strand hamstring autograft tendons were included.

Clinical outcome of arthroscopic suture fixation for tibial eminence fractures in adults.

Purpose: The purpose of this study was to evaluate the clinical outcome of arthroscopic suture fixation for tibial eminence fractures in adults.

Methods: Twelve patients with a mean age of 29.9 years (range, 18 to 45 years) were prospectively followed up after arthroscopic suture fixation for tibial eminence fractures.

Brucella arthritis of the knee, 1 year after revision of anterior cruciate ligament reconstruction.

Brucellosis is a zoonotic infection with a broad spectrum of clinical manifestations. The authors report the first case in the literature of septic arthritis of the knee 1 year after revision of anterior cruciate ligament reconstruction. Brucella melitensis biotype 3 was found in both synovial fluid and blood cultures.

Locked bucket-handle tears of both medial and lateral menisci with simultaneous anterior cruciate and medial collateral ligaments injury.

The authors report the case of a 38-year-old male who presented to the accident and emergency department with a locked knee after falling from a height. The knee was locked at 35° of flexion without any signs of instability in clinical examination. The patient was operated within 6 h from injury.

Acute, simultaneous tear of patellar tendon and ACL: possible mechanism of injury and rationality of the two-stage surgical treatment.

The authors report a case of a 47-year-old professional driver with an acute, simultaneous tear of patellar tendon and anterior cruciate ligament (ACL). The patient was treated in two stages. Acute patellar tendon repair and delayed (6-month postinjury) ACL reconstruction was performed.

Symptomatic ring-shaped lateral meniscus. MRI findings.

Ring-shaped lateral meniscus is a rare clinical entity that is usually asymptomatic. Moreover, diagnosis is always based on arthroscopic exploration of lateral meniscus. MRI has not been proven useful so far because the inner portion of the ring-shaped lateral meniscus is usually misinterpreted as a bucket-handle tear.

Isolated posterior cruciate ligament calcification.

The authors present a case of calcified posterior cruciate ligament (PCL). A 61-year-old female presented in our department reporting 12 months history of knee pain that was getting worse during the night. The patient was under medication for epileptic seizure, osteoporosis and hyperthyroidism.

Spontaneous, bilateral, quadriceps tendon rupture caused by local exposure to methidathion.

Spontaneous, bilateral, quadriceps tendon rupture is a rare injury. Many predisposing conditions have been reported that contribute to quadriceps tendon degeneration. We report a case of a 42-year-old farmer with spontaneous, bilateral, quadriceps tendon rupture and clear medical history.

Broken bioabsorbable femoral cross-pin as a cause of a chondral lesion after anterior cruciate ligament reconstruction.

We present a case of a chondral lesion after anterior cruciate ligament (ACL) reconstruction caused by femoral cross-pin breakage and intra-articular migration of the fragment. A 20-year-old man initially underwent ACL reconstruction using a hamstring autograft. The RigidFix bioabsorbable cross-pin (DePuy Mitek) was used for the femoral fixation.

RigidFix femoral fixation: a test for detecting inaccurate cross pin positioning.

The RigidFix Cross Pin System (DePuy Mitek, Raynham, MA) is a popular technique for femoral fixation of graft in ACL reconstruction. In some cases, though, cross pins miss the femoral tunnel resulting in inadequate proximal graft fixation. We present a simple test to detect the incorrect placement of cross pins.

Meniscal tears in the ACL-deficient knee: correlation between meniscal tears and the timing of ACL reconstruction.

Despite the fact that anterior cruciate ligament reconstruction (ACLR) is a common procedure, no clear guideline regarding the timing of reconstruction has been established. We hypothesized that there is a point in post injury period, after which significant increase in meniscal tears occurs. The purpose of this study was to derive a guideline in order to reduce the rate of secondary meniscal tears in the ACL-deficient knee.

Circumflex femoral vein thrombosis misinterpreted as acute hamstring strain.

The case of a 24-year-old female professional, long-distance runner who presented with acute proximal posterior thigh pain is reported. History and clinical findings were consistent with acute hamstring strain but MRI demonstrated circumflex femoral vein thrombosis. This is the first case of proximal posterior thigh pain caused by circumflex femoral vein thrombosis reported in the literature.

Mid-term clinical results of medial meniscus repair with the meniscus arrow in the unstable knee.

The medial meniscus is a secondary stabilizer to anterior tibial translation and provides significant stability, especially in an ACL-deficient knee. The purpose of this study is to evaluate the clinical outcome of medial meniscus repair in the unstable knee. Between 1997 and 2002, 11 patients, with a mean age of 25.