Effect of posterior tibial slope on knee biomechanics during functional activity.

Treatment of medial compartment knee osteoarthritis with high tibial osteotomy can produce an unintended change in the slope of the tibial plateau in the sagittal plane. The effect of changing posterior tibial slope (PTS) on cruciate ligament forces has not been quantified for knee loading in activities of daily living. The purpose of this study was to determine how changes in PTS affect tibial shear force, anterior tibial translation (ATT), and knee-ligament loading during daily physical activity.

Chondral resurfacing and high tibial osteotomy in the varus knee: survivorship analysis.

Background: Active patients with arthritic malalignment of the knee are difficult to manage. Arthroplasty, unicompartmental or total knee replacement, may not be appropriate in patients who desire to remain highly active. High tibial osteotomy has been recommended for the treatment of varus osteoarthritis to decrease pressure on the damaged medial compartment.

Variability of single-leg versus double-leg stance radiographs in the varus knee.

We evaluated measured radiographic parameter variability between single-leg stance (SLS) and double-leg stance (DLS) radiographs in patients with varus knee malalignment, indicated for high tibial osteotomy. Fifty-three consecutive knees (mean, 49 years; range, 18-79 years) were evaluated for varus thrust. SLS and DLS radiographs were obtained.

Posterior tibial slope after medial opening wedge high tibial osteotomy of the varus degenerative knee.

This study examined whether medial opening wedge osteotomy inadvertently changes posterior tibial slope and whether this change affects range of motion and functional outcomes. Lateral radiographs of 82 knees with varus arthrosis were reviewed to measure posterior tibial slope before and after medial opening wedge high tibial osteotomy. Anterior or posterior cruciate ligament-deficient knees were excluded.

Patient satisfaction after medial opening high tibial osteotomy and microfracture.

High tibial osteotomy has become an accepted treatment for patients with varus degenerative arthritis of the knee. We sought to determine factors associated with patient satisfaction and functional outcome following medial opening wedge high tibial osteotomy for the degenerative varus knee. Sixty-one patients (14 women and 47 men) undergoing medial opening wedge osteotomy and chondral resurfacing procedure (microfracture) for medial knee pain, with minimum 2-year follow-up, were identified through our clinical database.

A clinical composite score accurately detects meniscal pathology.

Purpose: Five common tests were used to diagnose meniscal tears when used as a composite score. We evaluated how effectively the composite examination, when performed in the presence of an anterior cruciate ligament (ACL) injury or degenerative joint disease (DJD), determined the presence of meniscal tears.

Methods: Data were collected prospectively on all patients at our clinic with a primary knee complaint.

Effect of functional bracing on knee injury in skiers with anterior cruciate ligament reconstruction: a prospective cohort study.

Background: The role of knee bracing in anterior cruciate ligament reconstructions is controversial.

Hypothesis: Functional bracing will have an effect on subsequent knee injury in skiers with anterior cruciate ligament reconstruction.

Study Design: Cohort study; Level of evidence, 3.

The effects of knee joint effusion on quadriceps electromyography during jogging.

To investigate and describe the influence of intra-articular effusion on knee joint kinematics and electromyographic (EMG) profiles during jogging. Thirteen individuals underwent a 20 cc 0.9% saline insufflation of the knee joint capsule and completed 8 jogging trials.

Comparison of tibial rotation strength in patients' status after anterior cruciate ligament reconstruction with hamstring versus patellar tendon autografts.

Objective: To determine if there are tibial rotational strength deficits in individuals treated with a semitendinosus/gracilis or bone-patella tendon-bone (BTB) autografts for ACL reconstruction.

Design: Retrospective.

Setting: Clinical practice and nonprofit research site.

Mechanisms of compensating for anterior cruciate ligament deficiency during gait.

Introduction: The quadriceps avoidance gait pattern may not be as common in ACL deficient (ACLd) gait as previously described.

Purpose: The purpose of this study was to investigate the existence of the quadriceps avoidance pattern in ACL deficient patients and to further identify gait compensations that may exist in this subject pool.

Methods: In the present study, hip, knee, and ankle gait kinematics, and kinetics and thigh EMG profiles were recorded and compared for 16 ACLd and 8 control subjects.

Chondral resurfacing and high tibial osteotomy in the varus knee.

Background: Treatment of patients with degenerative knees and varus malalignment presents a difficult clinical problem.

Hypothesis: Combining a medial opening wedge high tibial osteotomy with the microfracture chondral resurfacing procedure is a viable treatment option.

Study Design: Retrospective review of prospectively collected data.

Reliability, validity, and responsiveness of the Lysholm knee scale for various chondral disorders of the knee.

Background: The Lysholm knee scale is a condition-specific outcome measure that was originally designed to assess ligament injuries of the knee. The purpose of this study was to determine the psychometric properties of the Lysholm knee scale for various chondral disorders of the knee.

Methods: Test-retest reliability, internal consistency, content validity, criterion validity, construct validity, and responsiveness to change were determined for the Lysholm knee scale within subsets of an overall study population of 1657 patients with chondral disorders of the knee.

Gait retraining after anterior cruciate ligament reconstruction.

Objectives: To examine the effects of 2 gait retraining protocols on the gait patterns of patients with bone-patellar tendon-bone anterior cruciate ligament (ACL) reconstruction.

Design: Randomized control, repeated-measures design.

Setting: Private orthopedic center and research facility.

Early ACL reconstruction in combined ACL-MCL injuries.

This study reports 18 patients with 19 combined ligament injuries with complete anterior cruciate ligament (ACL) tear and a minimum grade II medial collateral ligament (MCL) tear who underwent early reconstruction of the ACL and nonoperative treatment of the MCL. Inclusion criteria included ACL reconstruction performed within 3 weeks of initial injury, no history of antecedent injury to the ipsilateral knee, and 2-year follow-up data. Associated injuries were noted in 11 patients including 6 isolated lateral meniscal tears, 1 isolated medial meniscal tear, 5 combined meniscal tears, 1 chondral injury, and 1 patellar fracture.

Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction.

Background: Relationships between objective assessment of ligament stability and subjective assessment of symptoms and function after anterior cruciate ligament reconstruction have not been established.

Hypothesis: Relationships exist between objective and subjective assessments after anterior cruciate ligament reconstruction.

Study Design: Case series.

Effects of braiding on tensile properties of four-strand human hamstring tendon grafts.

Background: Anterior cruciate ligament reconstruction is commonly performed with autogenous hamstring tendon grafts.

Purpose: To ascertain the effects of braiding on ultimate tensile strength and stiffness of hamstring tendon graft.

Study Design: Controlled laboratory study.

Gender differences in lower extremity kinematics, kinetics and energy absorption during landing.

Objective: To determine whether gender differences exist in lower extremity joint motions and energy absorption landing strategies between age and skill matched recreational athletes.

Design: Mixed factor, repeated measures design.

Background: Compared to males, females execute high demand activities in a more erect posture potentially predisposing the anterior cruciate ligament to greater loads and injury.

Effect of functional bracing on subsequent knee injury in ACL-deficient professional skiers.

The effect of functional bracing on subsequent knee injury in anterior cruciate ligament (ACL) deficient professional skiers was evaluated. A cohort of 180 ACL-deficient skiers was identified from a knee screening of 9410 professional skiers from 1991-1997. An ACL-deficient knee was defined by an abnormal examination (Lachman or pivot-shift) and a > or = 5-mm KT-1000 manual maximum difference.

Decreased range of motion following acute versus chronic anterior cruciate ligament reconstruction.

Eighty patients with acute anterior cruciate ligament (ACL) reconstruction were compared to 80 patients with chronic ACL reconstruction. Before reconstruction, all patients had 0 degrees-120 degrees active motion, performed a straight leg raise without loss of extension, and demonstrated good quadriceps control. At 3 months, 4 acute patients had decreased range of motion (<10 degrees-120 degrees), but none at 6 or 12 months, and did not require repeat surgery.

Landing adaptations after ACL reconstruction.

Purpose: The purpose of this study was to determine whether fully rehabilitated ACL reconstructed (ACLr) recreational athletes utilize adapted lower-extremity joint kinematics and kinetics during a high-demand functional task.

Methods: The kinematic and kinetic performance of 11 healthy and 11 hamstring ACLr recreational athletes were compared during a 60-cm vertical drop landing.

Results: At initial ground contact, the ACLr group demonstrated greater hip extension and ankle plantarflexion compared with the healthy group.

Determinants of patient satisfaction with outcome after anterior cruciate ligament reconstruction.

Background: The purpose of this study was to identify the determinants of patient satisfaction with the outcome after reconstruction of the anterior cruciate ligament.

Methods: A cohort of 201 patients undergoing primary reconstruction of the anterior cruciate ligament was studied prospectively. All patients were followed for a minimum of two years (mean, 35.