Management after acute injury of the anterior cruciate ligament (ACL). Part 3: Recommendation on surgical treatment.

Purpose: The aim of this consensus project was to give recommendations regarding surgical treatment of the anterior cruciate ligament (ACL) injured patient.

Methods: For this consensus process, an expert, steering and rating group was formed. In an initial online meeting, the steering group, together with the expert group, formed various key topic complexes for which multiple questions were formulated.

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).

Medial Collateral Ligament Reconstruction: A Gracilis Tenodesis for Anteromedial Knee Instability.

The main principle of the present medial collateral ligament reconstruction technique is to address anteromedial knee instability. Therefore, we describe a gracilis tenodesis with 2 functional bundles to reconstruct the deep and superficial medial collateral ligament. The proposed technique may be performed as an isolated or combined procedure with anterior cruciate ligament reconstruction.

The "WWHow" Concept for Prospective Categorization of Post-operative Severity Assessment in Mice and Rats.

The prospective severity assessment in animal experiments in the categories' non-recovery, mild, moderate, and severe is part of each approval process and serves to estimate the harm/benefit. Harms are essential for evaluating ethical justifiability, and on the other hand, they may represent confounders and effect modifiers within an experiment. Catalogs and guidelines provide a way to assess the experimental severity prospectively but are limited in adaptation due to their nature of representing particular examples without clear explanations of the assessment strategies.

Tunnel Convergence Rate in Combined Anteromedial Portal Anterior Cruciate Ligament and Anterolateral Structure Reconstructions Is Influenced by Anterior Cruciate Ligament Knee Flexion Angle, Tunnel Position, and Direction.

Purpose: The goal of the present study was to evaluate a potential tunnel convergence in combined anterior cruciate ligament (ACL) reconstruction using the anteromedial portal technique and lateral extra-articular tenodesis (LET).

Methods: Ten fresh frozen femora were dissected and a K-wires were inserted into the middle of the ACL stump, according to an ACL reconstruction at 110° and 140° knee flexion. ACL reconstruction at 120° and 130° was simulated.

Mutation patterns in recurrent and/or metastatic oropharyngeal squamous cell carcinomas in relation to human papillomavirus status.

Patients with HPV-driven (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) have a significantly improved overall survival compared to patients with HPV-negative (HPV-) OPSCC. Nevertheless, 13%-25% of patients with HPV+OPSCC develop local/distant recurrence (LDR) and have a course of disease similar to HPV-OPSCC. We hypothesize that HPV+OPSCCs of patients with LDR have a mutation frequency and pattern similar to HPV-OPSCCs, which is associated with severe outcome.

Medial collateral ligament reconstruction graft isometry is effected by femoral position more than tibial position.

Purpose: The purpose of this study was to examine the length change patterns of the native medial structures of the knee and determine the effect on graft length change patterns for different tibial and femoral attachment points for previously described medial reconstructions.

Methods: Eight cadaveric knee specimens were prepared by removing the skin and subcutaneous fat. The sartorius fascia was divided to allow clear identification of the medial ligamentous structures.

Investigating cortico-subcortical circuits during auditory sensory attenuation: A combined magnetoencephalographic and dynamic causal modeling study.

Sensory attenuation refers to the decreased intensity of a sensory percept when a sensation is self-generated compared with when it is externally triggered. However, the underlying brain regions and network interactions that give rise to this phenomenon remain to be determined. To address this issue, we recorded magnetoencephalographic (MEG) data from 35 healthy controls during an auditory task in which pure tones were either elicited through a button press or passively presented.

The Popliteus Bypass provides superior biomechanical properties compared to the Larson technique in the reconstruction of combined posterolateral corner and posterior cruciate ligament injury.

Purpose: This study aimed to compare the biomechanical properties of the popliteus bypass against the Larson technique for the reconstruction of a combined posterolateral corner and posterior cruciate ligament injury.

Methods: In 18 human cadaver knees, the kinematics for 134 N posterior loads, 10 Nm varus loads, and 5 Nm external rotational loads in 0°, 20°, 30°, 60,° and 90° of knee flexion were measured using a robotic and optical tracking system. The (1) posterior cruciate ligament, (2) meniscofibular/-tibial fibers, (3) popliteofibular ligament (PFL), (4) popliteotibial fascicle, (5) popliteus tendon, and (6) lateral collateral ligament were cut, and the measurements were repeated.

The superficial medial collateral ligament is the major restraint to anteromedial instability of the knee.

Purpose: The purpose of the present study was to determine how the medial structures and ACL contribute to restraining anteromedial instability of the knee.

Methods: Twenty-eight paired, fresh-frozen human cadaveric knees were tested in a six-degree of freedom robotic setup. After sequentially cutting the dMCL, sMCL, POL and ACL in four different cutting orders, the following simulated clinical laxity tests were applied at 0°, 30°, 60° and 90° of knee flexion: 4 Nm external tibial rotation (ER), 4 Nm internal tibial rotation (IR), 8 Nm valgus rotation (VR) and anteromedial rotation (AMR)-combined 89 N anterior tibial translation and 4 Nm ER.

Grey-matter abnormalities in clinical high-risk participants for psychosis.

The current study examined the presence of abnormalities in cortical grey-matter (GM) in a sample of clinical high-risk (CHR) participants and examined relationships with psychosocial functioning and neurocognition. CHR-participants (n = 114), participants who did not fulfil CHR-criteria (CHR-negative) (n = 39) as well as a group of healthy controls (HC) (n = 49) were recruited. CHR-status was assessed using the Comprehensive Assessment of At-Risk Mental State (CAARMS) and the Schizophrenia Proneness Interview, Adult Version (SPI-A).

Dynamic Restraints of the Medial Side of the Knee: The Semimembranosus Corner Revisited.

Background: Little is known about the dynamic restraints of the semimembranosus muscle (SM).

Purpose And Hypothesis: The goal of the present study was to elucidate the role of (1) passive and (2) active restraints to medial-side instability and to analyze (3) the corresponding tightening of the posteromedial structures by loading the SM. It was hypothesized that points 1 to 3 will significantly restrain medial knee instability.

Neuropsychological deficits in participants at clinical high risk for psychosis recruited from the community: relationships to functioning and clinical symptoms.

Background: The current study examined the pattern of neurocognitive impairments in a community-recruited sample of clinical high-risk (CHR) participants and established relationships with psychosocial functioning.

Methods: CHR-participants (n = 108), participants who did not fulfil CHR-criteria (CHR-negatives) (n = 42) as well as a group of healthy controls (HCs) (n = 55) were recruited. CHR-status was assessed using the Comprehensive Assessment of At-Risk Mental States (CAARMS) and the Schizophrenia Proneness Instrument, Adult Version (SPI-A).

Biomechanics of the Anterolateral Structures of the Knee.

This article describes the complex anatomic structures that pass across the lateral aspect of the knee, particularly the iliotibial tract and the underlying anterolateral ligament and capsule. It provides data on their strength and roles in controlling tibiofemoral joint laxity and stability. These findings are discussed in relation to surgery to repair or reconstruct the anatomic structures, or to create tenodeses with similar effect.

FACS-Assisted CRISPR-Cas9 Genome Editing Facilitates Parkinson's Disease Modeling.

Genome editing and human induced pluripotent stem cells hold great promise for the development of isogenic disease models and the correction of disease-associated mutations for isogenic tissue therapy. CRISPR-Cas9 has emerged as a versatile and simple tool for engineering human cells for such purposes. However, the current protocols to derive genome-edited lines require the screening of a great number of clones to obtain one free of random integration or on-locus non-homologous end joining (NHEJ)-containing alleles.

Kinematics of Different Components of the Posterolateral Corner of the Knee in the Lateral Collateral Ligament-intact State: A Human Cadaveric Study.

Purpose: To determine the static stabilizing effects of different anatomical structures of the posterolateral corner (PLC) of the knee in the lateral collateral ligament (LCL)-intact state.

Methods: Thirteen fresh-frozen human cadaveric knees were dissected and tested using an industrial robot with an optical tracking system. Kinematics were determined for 134 N anterior/posterior loads, 10 N m valgus/varus loads, and 5 N m internal/external rotatory loads in 0°, 20°, 30°, 60°, and 90° of knee flexion.

Anterior Cruciate Ligament Soft Tissue Graft Fixation in the Elderly: Is There a Reason to Use Interference Screws? A Human Cadaver Study.

Purpose: To analyze the ultimate failure load, yield load, stiffness, and cyclic resistance of different anterior cruciate ligament (ACL) soft tissue graft fixation techniques in osteopenic bone.

Methods: In this study, 24 fresh-frozen human cadaveric tibiae (mean age 82.6 years; range 56-96; 6 male and 6 female donors) were used.

There is no difference between quadriceps- and hamstring tendon autografts in primary anterior cruciate ligament reconstruction: a 2-year patient-reported outcome study.

Purpose: Graft choice for anterior cruciate ligament (ACL) reconstruction is crucial, however the optimal graft source remains a topic of controversy. The purpose of this study is to compare subjective and functional patient-reported outcomes (PRO) after single-bundle ACL reconstruction using quadriceps tendon (QT) or hamstring tendon (HT) autografts for single-bundle ACL reconstruction. We hypothesize that there is no difference in patient-reported functional outcomes after ACL reconstruction using either HT- or QT autograft.

Trends and incidences of ligament-surgeries and osteotomies of the knee: an analysis of German inpatient records 2005-2013.

Introduction: In Germany most surgical procedures of the ligaments of the knee and correcting osteotomies of the knees are performed within an inpatient setting. The purpose of this study was to analyze the available data to assess epidemiological trends and incidences in inpatient knee joint surgery.

Materials And Methods: Approximately 154 million anonymized DRG inpatient records were collected by the German Federal Statistical Office between 2005 and 2013.

Should the Ipsilateral Hamstrings Be Used for Anterior Cruciate Ligament Reconstruction in the Case of Medial Collateral Ligament Insufficiency? Biomechanical Investigation Regarding Dynamic Stabilization of the Medial Compartment by the Hamstring Muscles.

Background: Semitendinosus and gracilis muscles are frequently harvested for autologous tendon grafts for cruciate ligament reconstruction. This study investigated the joint-stabilizing effects of these hamstring muscles in cases of insufficiency of the medial collateral ligament (MCL).

Hypotheses: First, both the semitendinosus and gracilis muscles can actively stabilize the joint against valgus moments in the MCL-deficient knee.

Intra-articular tibial plateau fracture characteristics according to the "Ten segment classification".

Background: Currently existing classifications of tibial plateau fractures do not help to guide surgical strategy. Recently, a segment-based mapping of the tibial plateau has been introduced in order to address fractures with a fracture-specific surgical approach. The goal of the present study was to analyze incidence and fracture specifics according to a new 10-segment classification of the tibial plateau.

Evaluation of biomechanical properties: are porcine flexor tendons and bovine extensor tendons eligible surrogates for human tendons in in vitro studies?

Introduction: Porcine flexor tendons, bovine extensor tendons, and human (semitendinosus) tendons are frequently used as substitutes for human ACL grafts in biomechanical in vitro studies. This study compares the biomechanical properties and structural differences of these tendons.

Materials And Methods: In this biomechanical study, fresh-frozen porcine flexor tendons, bovine extensor tendons, and human semitendinosus tendons were used (n = 36).