Meniscal tear analysis in anterior cruciate ligament rupture: A retrospective comparison of early versus delayed intervention.

Introduction: Combined anterior cruciate ligament (ACL) and meniscal tear patterns and their effect on knee stability have been widely researched, however, their evolution and repairability from time of injury have been scarcely addressed. When addressed with delay, meniscal lesions associated with ACL tears may increase in severity and irreparability. This study aims to investigate the incidence, rate and pattern of meniscus tears in the context of ACL deficient knees and to assess the meniscal condition in early versus late ACL reconstruction (ACLR).

Association Between Articular Incongruence After Trochleoplasty and Long-term Patellofemoral Osteoarthritis.

Background: Trochleoplasty has shown promising results in selected patients with patellar instability. However, concerns persist regarding its potential relationship with long-term osteoarthritis (OA) and the underlying causes.

Purpose: To evaluate the correlation between postoperative patellofemoral incongruence after trochleoplasty and long-term OA.

Spacers in two-stage strategy for periprosthetic infection.

In two-stage revision of infected implants, the first stage involves removing the implant and implanting a joint spacer, and the second stage involves implanting a new prosthesis at least 6 weeks later. Spacers have two main functions: local administration of high-dose antibiotics, and preservation of the joint space by reducing soft tissue retraction and improving patient comfort until reimplantation. The present review aims to detail the necessary characteristics of antibiotics added to cement to achieve good joint diffusion, to describe the steps of two-stage revision, and to present the types of spacer available according to the joint and complications.

Medial orientation of the trochlear groove is a strong indicator of high-grade trochlear dysplasia.

Purpose: The objective is to evaluate the orientation of the trochlear groove in patients with objective patellar instability (OPI) compared to a control group. The hypothesis is that the trochlear groove angle (TGA) is correlated with the severity of the trochlear dysplasia.

Methods: From 2019 to 2023, magnetic resonance imaging of 82 knees with OPI were compared with 82 control knees.

Ten-year minimal follow-up of lateral opening wedge distal femoral osteotomy for lateral femorotibial osteoarthritis: Good survivorship and high patient satisfaction.

Purpose: This study aimed (1) to determine complications and survival rates of lateral opening wedge distal femoral osteotomy (LOW-DFO) in the long term, (2) to assess their clinical outcomes in the long term and (3) to identify risk factors of failure.

Methods: Between 1991 and 2011, 62 LOW-DFOs were performed in the same department. Inclusion criteria were all isolated LOW-DFO performed for isolated lateral tibiofemoral osteoarthritis and valgus malalignment, with a minimum 10-year follow-up.

Dynamic Magnetic Resonance Imaging Protocol: An Effective and Useful Tool to Assess Discoid Lateral Meniscus Instability in Children.

Objectives: One of the most common symptoms in cases of discoid lateral meniscus (DLM) in children is a "snapping" knee. The clock in extension, followed by a pop in flexion, perceived by the clinician, reflects the meniscal displacement caused by the peripheral meniscocapsular detachment. Standard magnetic resonance imaging (MRI) results in a 40% false-negative rate for detecting this instability.

Evaluation of Anterior Tibial Translation Under Physiological Axial Load After ACL Reconstruction With Lateral Extra-articular Tenodesis.

Background: Postoperative laxity correlates with negative clinical outcomes after anterior cruciate ligament reconstruction (ACLR). The influence of lateral extra-articular tenodesis (LET) on anteroposterior translation is unclear.

Purpose/hypothesis: This study aimed to evaluate the reduction in radiographic static anterior tibial translation (SATT) and dynamic anterior tibial translation (DATT) after LET as an adjunctive procedure to ACLR.

Anterior cruciate ligament zoobiquity: Can man's best friend tell us we are being too cautious with the implementation of osteotomy to correct posterior tibial slope.

Anterior cruciate ligament (ACL) reconstruction (ACLR) is used to treat clinical instability post ACL rupture, however, there is a high rate of incomplete return to sport and rerupture. There is increasing interest in posterior tibial slope as an intrinsic risk factor for ACLR failure and persistent instability. Zoobiquity describes the collaboration between the human and veterinary professions in order to advance the scientific understanding of both fields.

Absorbable Sutures Repair Without Meniscopexy, Results in Superior Outcomes for Discoid Lateral Meniscus With Meniscocapsular Anterior Detachment in Children.

Background: Despite the fact that meniscocapsular anterior detachment is the most common location of instability in children with a Discoid Lateral Meniscus (DLM), there is a lack of consensus about the type of repair that should be utilized for stabilization. The aim of this study was to determine the best fixation method for anterior detachment of DLM in children. Our hypothesis was that excessive rigidity with fixation would restrict meniscal mobility and increase the rate of failure or prevent full knee flexion.

Patellar tendon angle is not elevated in ACL-injured subjects, suggesting methods to correct should focus on prehabilitation and rehabilitation rather than surgery.

Purpose: The aim of the study was to explore if the patellar tendon angles (PTAs) is an intrinsic risk factor for anterior cruciate ligament (ACL) rupture. We hypothesised that the PTAs will be increased in ACL rupture patients compared to matched controls.

Methods: We performed a retrospective radiographic cohort study.

Transtibial Lateral Meniscal Root Repair Technique to Appose Remnant Root With Torn Body: The Double Compression Knot.

Anterior cruciate ligament reconstructions are often performed with associated procedures, most commonly for associated meniscal tears. The lateral meniscal root tear is a commonly associated injury, which increases rotational instability and results in altered tibiofemoral biomechanics. Lateral meniscectomy results in poorer functional and long-term outcomes, making repair vital.

Radiographic Investigation of Coronal Plane and Patellar Height and Changes Following Tibial Deflection Osteotomy for Correction of Tibial Slope in Combination With ACL Reconstruction.

Background: A tibial deflexion osteotomy (TDO) is performed to decrease the sagittal tibial slope to reduce the relative risk of anterior cruciate ligament (ACL) reconstruction (ACLR) graft failure. Given that coronal plane osteotomies can cause consequential changes in the sagittal plane to patellar height and tibial slope, potential changes to coronal plane alignment and patellar height can result after a sagittal plane osteotomy.

Purpose: To compare preoperative and postoperative coronal plane alignment after TDO, as well as to analyze the effect of the osteotomy on patellar height.

A non-weight bearing protocol after ACL reconstruction improves static anterior tibial translation in patients with elevated slope and increased weight bearing tibial anterior translation.

Purpose: Aim of this study is to evaluate the impact of a non-weight bearing (NWB) protocol within 21 post-operative days after anterior cruciate ligament (ACL) reconstruction on static and dynamic anterior tibial translations (SATT and DATT, respectively). The hypothesis is that delayed WB would improve ATT at 9 months follow-up.

Methods: A series of patients treated with ACL reconstruction was retrospectively reviewed, comparing a group with immediate post-operative weight bearing (WB group) and a group without post-operative weight bearing (NWB group).

Discoid lateral meniscus instability in children: part II.: Repair first to minimise the saucerisation.

Purpose: Despite an improved understanding of discoid lateral meniscus (DLM), the treatment of symptomatic discoid lateral meniscus remains controversial.

Methods: The aim of this retrospective, single-centred, consecutive-case study was to evaluate the clinical outcome of 60 DLM treated arthroscopically by the "meniscoplasty or saucerisation-suture" technique in children and adolescents [median (range) age 11 (4-17) years], and to investigate surgical failures. The instability was assessed before any saucerisation.

Delaying anterior cruciate ligament reconstruction increases the rate and severity of medial chondral injuries.

Aims: The aim of this study was to evaluate the association between chondral injury and interval from anterior cruciate ligament (ACL) tear to surgical reconstruction (ACLr).

Methods: Between January 2012 and January 2022, 1,840 consecutive ACLrs were performed and included in a single-centre retrospective cohort. Exclusion criteria were partial tears, multiligament knee injuries, prior ipsilateral knee surgery, concomitant unicompartmental knee arthroplasty or high tibial osteotomy, ACL agenesis, and unknown date of tear.

Discoid lateral meniscus instability in children: part I. A new grading system of instability to clarify natural history.

Objective: In young patients, the discoid lateral meniscus (DLM) usually becomes symptomatic at the time of peripheral rim instability of a complete discoid form. However, little is known about the natural history of meniscal instability. The aim was to detect hidden forms of presentation of instability using the history and clinical mechanical symptoms of instability.

Delaying ACL reconstruction is associated with increased rates of medial meniscal tear.

Purpose: The aim of this study was to evaluate the relationship between the time from injury to ACL reconstruction (ACLR) and the rate as well as repairability of meniscal tears. Secondary aims were to evaluate the relationship between meniscal injury and Tegner Activity Scale, age, BMI, and gender.

Methods: Between 2012 and 2022, 1,840 consecutive ACLRs were performed.

Four to 6° Is the Target Posterior Tibial Slope After Tibial Deflection Osteotomy According to the Knee Static Anterior Tibial Translation.

Purpose: To correlate changes in posterior tibial slope (PTS) with changes to static anterior tibial translation (SATT) with tibial deflexion osteotomy (TDO), in order to define a target postoperative tibial slope based on postoperative SATT.

Methods: We reviewed a consecutive series of primary and revision anterior cruciate ligament reconstruction with TDO between 2011 and 2022. PTS and SATT were measured pre- and postoperatively directly from the radiographs by 2 independent reviewers.

Tibial Tubercle Osteotomy in Revision Total Knee Arthroplasty for Periprosthetic Infection: Indications and Outcomes.

Background: Adequate exposure is essential in revision total knee arthroplasty (RTKA). Tibial tubercle osteotomy (TTO) enhances exposure, but its use is controversial in the setting of periprosthetic infection. The purposes of this study were to determine (1) the rates of complications and revisions due to TTO during RTKA in the setting of a periprosthetic infection, (2) the rate of septic failure, and (3) functional outcomes at a minimum 2-year follow-up.

Tibial tubercule osteotomy during the revision of total knee arthroplasty: The technique of a referral center with 10 years of experience.

Introduction: The Tibial Tubercle Osteotomy (TTO) technique, by lifting the distal bony attachment of the extensor mechanism, allows efficient knee exposure while preserving soft tissues and tendinous attachments. The surgical technique seems essential to obtain satisfying outcomes with a low rate of specific complications. Several tip sand tricks can be used to improve this procedure during the revision of total knee arthroplasty (RTKA).

Misdiagnosed cartilaginous PCL avulsion in young children.

Posterior Cruciate Ligaments injuries are rare in children and usually due to bony avulsion fractures or midsubstance tears. This study focused on cartilaginous avulsions initially misdiagnosed despite of MRI assessment. Two 6-year-old boys had cartilaginous avulsion fracture injury at the femoral attachment of the PCL.