Proximal tibial anatomical axis and anterior tibial cortex-based measurements of posterior tibial slope on lateral radiographs differ least from actual posterior tibial slope-A biomechanical study.

Purpose: To compare different measurement techniques of the posterior tibial slope (PTS) on lateral radiographs with the actual in situ PTS and evaluate the effect of tibial malrotation and image section length.

Methods: Actual PTS was measured on eight fresh-frozen tibiae using a portable 6-axis measuring arm with an accuracy of ±0.01°.

The Effect of C-Arm Position on Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction.

Background: Medial patellofemoral ligament (MPFL) reconstruction is a common treatment for patellar instability. Yet nearly 40% of revisions result from femoral tunnel misplacement. One reason may be the positioning of the C-arm relative to the knee.

Anterior Slope-Modifying Osteotomies Alter the Length Change Behavior of the Superficial Medial Collateral Ligament: A Biomechanical Study.

Background: Increased tibial slope has been shown to lead to higher rates of anterior cruciate ligament graft failure. A slope-decreasing osteotomy can reduce in situ anterior cruciate ligament force and may mitigate this risk. However, how this procedure may affect the length change behavior of the medial ligamentous structures is unknown.

Specific fibre areas in the femoral footprint of the posterior cruciate ligament act as a major contributor in resisting posterior tibial displacement: A biomechanical robotic investigation.

Purpose: Similar to the anterior cruciate ligament, the femoral footprint of the posterior cruciate ligament (PCL) is composed of different fibre areas, possibly having distinct biomechanical functions. The aim of this study was to determine the role of different fibre areas of the femoral footprint of the PCL in restraining posterior tibial translation (PTT).

Methods: A sequential cutting study was performed on eight fresh-frozen human knee specimens, utilizing a six-degrees-of-freedom robotic test setup.

Combined PCL instabilities cannot be identified using posterior stress radiographs in external or internal rotation: A cadaveric study.

Purpose: Posterior stress radiography is recommended to identify isolated or combined posterior cruciate ligament (PCL) deficiencies. The posterior drawer in internal (IR) or external rotation (ER) helps to differentiate between these combined instabilities. The purpose of this study was to evaluate posterior stress radiography (PSR) in isolated and combined PCL deficiency with IR and ER compared to PSR in neutral rotation (NR) for diagnosing combined PCL instabilities.

Collateral ligament strain is linearly related to coronal lower limb alignment: A biomechanical study.

Purpose: The purpose of this study was to analyse the influence of coronal lower limb alignment on collateral ligament strain.

Methods: Twelve fresh-frozen human cadaveric knees were used. Long-leg standing radiographs were obtained to assess lower limb alignment.

Comparison of Time-Zero Primary Stability Between a Biodegradable Magnesium Bone Staple and Metal Bone Staples for Knee Ligament Fixation: A Biomechanical Study in a Porcine Model.

Background: Bone staples have been shown previously to be a viable modality for cortical tendon graft fixation in ligament knee surgery. However, soft tissue reactions have been reported, making implant removal necessary. Magnesium alloys are a promising material for biodegradable orthopaedic implants, with mechanical properties closely resembling those of human bone.

The anteromedial retinaculum in ACL-injured knees: An overlooked injury?

Purpose: The purpose of this study was to retrospectively analyse the pattern of injury to the medial knee structures in anterior cruciate ligament (ACL) injured patients. It was hypothesised that anteromedial injuries would be more common than posteromedial lesions.

Methods: One hundred and twenty subjects aged 18-25 years with a primary ACL injury were included.

Exposure of Hoffa Fractures Is Improved by Posterolateral and Posteromedial Extensile Approaches: A Qualitative and Quantitative Anatomical Study.

Background: The current literature lacks recommendations regarding surgical approaches to best visualize and reduce Hoffa fractures. The aims of this study were to (1) define surgical corridors to the posterior portions of the lateral and medial femoral condyles and (2) compare the articular surface areas visible with different approaches.

Methods: Eight fresh-frozen human cadaveric knees (6 male and 2 female donors; mean age, 68.

Additional Plate Fixation of Hinge Fractures After Varisation Distal Femoral Osteotomies Provides Favorable Torsional Stability: A Biomechanical Study.

Background: Hinge fractures are considered risk factors for delayed or nonunion of the osteotomy gap in distal femoral osteotomies (DFOs). Limited evidence exists regarding the treatment of hinge fractures after DFO, which could improve stability and thus bone healing.

Purpose: To (1) examine the effect of hinge fractures on the biomechanical properties of the bone-implant construct, (2) evaluate the biomechanical advantages of an additional fixation of a hinge fracture, and (3) test the biomechanical properties of different types of varisation DFOs.

K2.1 is a regulator of inflammatory cell responses in idiopathic inflammatory myopathies.

K2.1 (TREK1), a two-pore domain potassium channel, has emerged as regulator of leukocyte transmigration into the central nervous system. In the context of skeletal muscle, immune cell infiltration constitutes the pathogenic hallmark of idiopathic inflammatory myopathies (IIMs).

[Injuries of the medial side of the knee : When and how should they be treated?].

Different medial structures are responsible for restraining valgus rotation, external rotation, and anteromedial rotation. When injured this can result in various degrees of isolated and combined instabilities. In contrast to earlier speculation, the posterior oblique ligament (POL) is no longer considered to be the main stabilizer of anteromedial rotatory instability (AMRI).

Interference screws manufactured from magnesium display similar primary stability for soft tissue anterior cruciate ligament graft fixation compared to a biocomposite material - a biomechanical study.

Purpose: Biodegradable interference screws (IFS) can be manufactured from different biomaterials. Magnesium was previously shown to possess osteoinductive properties, making it a promising material to promote graft-bone healing in anterior cruciate ligament reconstruction (ACLR). The purpose of this study was to compare IFS made from magnesium to a contemporary biocomposite IFS.

Recurrent Instability Rate and Subjective Knee Function following Accelerated Rehabilitation after ACL Reconstruction in Comparison to a Conservative Rehabilitation Protocol.

Introduction: The Purpose of the present study was to assess the outcome of anterior cruciate ligament reconstruction (ACLR) with an accelerated rehabilitation protocol and to compare it to a conservative rehabilitation protocol. It was hypothesized that an accelerated rehabilitation protocol, including brace-free early weight bearing, would result in a higher rate of recurrent instability and revision surgery compared to a conservative rehabilitation protocol.

Methods: From 2016 to 2017, two different rehabilitation protocols for isolated ACLR were used at a high-volume knee surgery center.

Refixation of a Large Osteochondral Fragment with Magnesium Compression Screws-A Case Report.

Introduction: Osteochondrosis dissecans (OCD) is a disease affecting the subchondral bone and the overlying articular cartilage. The etiology is most likely a combination of biological and mechanical factors. The incidence is highest in children >12 years old and it predominantly affects the knee.

The Bone Bridge for Tibial ACL Graft Fixation: A Biomechanical Analysis of Different Tibial Fixation Methods for ACL Reconstruction.

Background: The tibial fixation site is considered the weak link in anterior cruciate ligament (ACL) reconstruction, and conflicting results regarding the biomechanical properties of various fixation methods have been reported.

Purpose: To examine knots tied over a bone bridge and its biomechanical properties as a suitable tibial fixation method in ACL reconstruction.

Study Design: Controlled laboratory study.

Qualitative and Quantitative Assessment of the Medial Patellar Retinaculum Anatomy: the Anteromedial Side of the Knee Revisited.

Background: In the current literature, studies on the anatomy of the anteromedial region of the knee are scarce. However, the anteromedial structures, especially the longitudinal medial patellar retinaculum (MPR), may play an important role in restraining external tibial rotation.

Purpose: To conduct a layer-by-layer dissection of the anteromedial side of the knee and describe qualitatively and quantitatively the MPR anatomy pertaining to surgically relevant landmarks.

The Biomechanical Stability of Bone Staples in Cortical Fixation of Tendon Grafts for Medial Collateral Ligament Reconstruction Depends on the Implant Design.

Background: The promising biomechanical stability of bone staples (BSs) in cortical fixation of tendon grafts for medial collateral ligament (MCL) reconstruction has been revealed by a previous investigation. However, it is currently unknown if the biomechanical stability of cortical fixation of tendon grafts depends on the BS design.

Purpose: To assess the biomechanical stability of cortical fixation of tendon grafts in knee surgery using 4 different BS designs.

Comparable Instrumented Knee Joint Laxity and Patient-Reported Outcomes After ACL Repair With Dynamic Intraligamentary Stabilization or ACL Reconstruction: 5-Year Results of a Randomized Controlled Trial.

Background: Technical innovation has led to the renaissance of anterior cruciate ligament (ACL) repair in the past decade.

Purpose/hypothesis: The present study aimed to compare instrumented knee joint laxity and patient-reported outcomes (PROs) after ACL repair with those after primary ACL reconstruction for acute isolated ACL tears. It was hypothesized that ACL repair would lead to comparable knee joint stability and PROs at 5 years postoperatively in comparison with ACL reconstruction.

[Ligament injuries in tibial plateau fractures].

Fracture dislocations of the proximal tibia are associated with a markedly high incidence of ligament ruptures. Despite knowledge on the frequency of accompanying ligament injuries, even now neither adequate diagnostics nor targeted treatment of associated ligament injuries are the gold standard in the treatment algorithm for tibial plateau fractures. To be able to assess the risk and the type of accompanying ligament injuries in tibial plateau fractures, it is recommended to decidedly analyze the fracture morphology.

Bone Staples Provide Favorable Primary Stability in Cortical Fixation of Tendon Grafts for Medial Collateral Ligament Reconstruction: A Biomechanical Study.

Background: The use of the interference screw (IFS) for the cortical fixation of tendon grafts in knee ligament reconstruction may lead to converging tunnels in the multiligament reconstruction setting. It is unknown whether alternative techniques using modern suture anchor (SA) or bone staple (BS) fixation provide sufficient primary stability.

Purpose: To assess the primary stability of cortical fixation of tendon grafts for medial collateral ligament (MCL) reconstruction using modern SA and BS methods in comparison with IFS fixation.

[A rare cause of an acutely locked knee joint: superior patellar dislocation].

The case of a 56-year-old male patient with locking of the knee in extension without trauma is presented. Patient history, clinical examination and radiographs confirmed a superior dislocation of the patella. Closed reduction led to full weight bearing with free range of motion without further complaints.

Shoulder injuries in polytraumatized patients: an analysis of the TraumaRegister DGU®.

Background: The aim of the present study was to analyze the prevalence, epidemiology and relevance of shoulder injuries in polytraumatized patients in a large national trauma database. We hypothesize a high prevalence of shoulder injuries in traffic accidents and a high prevalence of concomitant injuries of the thorax leading to an aggravated clinical course and higher Injury Severity Score (ISS). Furthermore, we hypothesize an increased rate of surgical treatment with the severity of the injury.