| 1. |
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| 2. |
- Hoe-Hansen, Carsten, 1955-, et al.
(author)
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The Clinical Effect of Ketoprofen After Arthroscopic Subacromial Decompression : A Randomized Double-Blind Prospective Study
- 1999
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In: Arthroscopy. - 0749-8063 .- 1526-3231. ; 15:3, s. 249-252
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Journal article (peer-reviewed)abstract
- The purpose of the study was to evaluate the clinical effect of ketoprofen after arthroscopic subacromial decompression (ASD). The design was randomized, prospective, and double-blind, with a placebo control group. Forty-one consecutive patients with subacromial impingement syndrome, were randomized to treatment with ketoprofen 200 mg once daily or placebo for 6 weeks following ASD. For additional analgesia, patients used paracetamol if necessary. Clinical follow-up was performed at 6 weeks and at 2 years postoperatively. At the 6-week follow-up, the patients treated with ketoprofen had a statistically significant increase in UCLA total score (P < .05), range of movement (P < .05), and satisfaction (P < .05), and they had significantly less pain (P < .05). There was no statistical difference between the ketoprofen and placebo groups regarding strength. Patients receiving ketoprofen had significantly less need for additional analgesia (P < .05). At the 2-year follow-up, there were no differences in the scores between the ketoprofen and placebo group.
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| 3. |
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| 4. |
- Tegner, Yelverton, et al.
(author)
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Derotation brace and knee function in patients with anterior cruciate ligament tears
- 1985
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In: Arthroscopy. - 0749-8063 .- 1526-3231. ; 1:4, s. 264-267
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Journal article (peer-reviewed)abstract
- In this article we have tested a ready-made brace to evaluate whether it could improve function in the anterior cruciate ligament injured patient. All patients had their full extent of injury mapped out at arthroscopy. We believe that arthroscopy before treatment for a torn anterior cruciate ligament injury is necessary in order to treat meniscus lesions that could interfere with the rehabilitation. In this study, 26 patients were unstable with a positive pivot-shift, and 16 patients were operated on and thus stable. All patients performed a performance test with and without the brace in a randomized order. Before the start of the investigation, we postulated that patients with a quadriceps atrophy who were unstable would improve their function with the derotation brace. We could not find any effects of the brace in this study. The brace did not significantly improve function in the group of patients who were unstable with a quadriceps atrophy. On the other hand, the brace did not impair function in the patients. We conclude that to be able to improve knee function in the unstable knee, other modes of treatment than bracing are necessary. Bracing should be seen as a complement to these other treatments.
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| 5. |
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| 6. |
- Adolfsson, Lars, 1955-
(author)
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Arthroscopic removal of os centrale carpi causing wrist pain.
- 2000
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In: Arthroscopy. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 16, s. 537-539
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Journal article (peer-reviewed)abstract
- The Os centrale carpi is a relatively rare accessory carpal bone of the wrist that infrequently has been reported to cause symptoms. This report describes 2 cases where an apparently mobile Os centrale carpi caused painful clicking and crepitus and where the symptoms disappeared after arthroscopic removal of the ossicles.
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| 7. |
- Andersson, Daniel, et al.
(author)
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Treatment of anterior cruciate ligament injuries with special reference to surgical technique and rehabilitation: an assessment of randomized controlled trials.
- 2009
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 25:6, s. 653-85
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Journal article (peer-reviewed)abstract
- The primary aim was to investigate and assess the current evidence of randomized controlled trials (RCTs) on anterior cruciate ligament (ACL) injuries, with special reference to the choice of surgical techniques and aspects of rehabilitation. A secondary aim was to clarify relative strengths and weaknesses of the selected studies, resolve literature conflicts, and finally, evaluate the need for further studies.
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| 8. |
- Andersson, Jonny K, 1972
(author)
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Author's Reply.
- 2015
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 31:10, s. 1852-3
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Journal article (other academic/artistic)
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| 9. |
- Andersson, Jonny K, 1972, et al.
(author)
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Efficacy of Magnetic Resonance Imaging and Clinical Tests in Diagnostics of Wrist Ligament Injuries: A Systematic Review.
- 2015
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 31:10
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Journal article (peer-reviewed)abstract
- To investigate the diagnostic performance of magnetic resonance imaging (MRI) and clinical provocative tests on injuries to the triangular fibrocartilage complex (TFCC), the scapholunate (SL) ligament, and the lunotriquetral (LT) ligament.
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| 10. |
- Andersson-Molina, Helene, et al.
(author)
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Arthroscopic Partial and Total Meniscectomy : A Long-term Follow-up Study With Matched Controls
- 2002
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In: Arthroscopy. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 18:2, s. 183-189
-
Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study was to compare the clinical and radiographic outcome of arthroscopic partial and total meniscectomy.Type of Study: Retrospective outcome study.Methods: Thirty-six male patients with stable knees, no previous knee injury, and arthroscopic meniscectomy were matched into 2 groups: partial or total. In addition, a group of individuals with no known history of knee injury was matched to each patient with meniscectomy. All patients were re-examined by a clinical and radiographic examination 14 years after surgery.Results: At follow-up, radiographic changes, including Fairbank changes and joint space narrowing, were seen in 6 of 18 patients (33%) after partial meniscectomy and in 13 of 18 patients (72%) after total meniscectomy (P < .05). Joint space narrowing >50% of the joint space was seen in 1 patient after partial meniscectomy but was present in 7 patients after total meniscectomy. In the healthy controls, 4 of 36 patients (11%) had radiographic changes but none had joint space narrowing. Fourteen years after surgery almost 70% of patients had a Lysholm score >94 (i.e., normal). Only 5 of 36 patients (14%) in the total meniscectomy group had knee symptoms during activities of daily living. A similar decline in activity levels according to Tegner was seen over time in the control group and in the 2 meniscectomy groups. Conclusions: The frequency of radiographic changes 14 years after meniscectomy is related to the size of the meniscus removed, but the grades of these changes are low and have little influence on activity and knee function.
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| 11. |
- Ardern, Clare, et al.
(author)
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Satisfaction With Knee Function After Primary Anterior Cruciate Ligament Reconstruction Is Associated With Self-Efficacy, Quality of Life, and Returning to the Preinjury Physical Activity
- 2016
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In: Arthroscopy. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 32:8, s. 1631-
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Journal article (peer-reviewed)abstract
- Purpose: To assess whether patient-reported outcomes (psychological factors, appraisals of knee function, and physical activity participation) were associated with satisfaction with knee function after anterior cruciate ligament (ACL) reconstruction. Methods: Participants who were aged 18 to 45 years and a minimum 12 months post primary ACL reconstruction completed a questionnaire battery evaluating knee self-efficacy, knee-related quality of life, self-reported function, and physical activity participation. Participants' responses to the question "If you were to spend the rest of your life with your knee just the way it has been in the last week, would you feel.... (7-point ordinal scale; 1 = happy, 7 = unhappy)" were categorized as satisfied, mostly satisfied, or dissatisfied and used as the primary outcome. Ordinal regression was used to examine associations between independent variables and the primary outcome. Results: A total of 177 participants were included at an average of 3 years after primary ACL reconstruction. At follow-up, 44% reported they would be satisfied, 28% mostly satisfied, and 28% dissatisfied with the outcome of ACL reconstruction. There were significant differences in psychological responses and appraisal of knee function between the 3 groups (P = .001), and significantly more people in the satisfied group had returned to their preinjury activity (58%) than in the mostly satisfied (28%) and dissatisfied (26%) groups (P = .001). Multivariable analysis demonstrated that the odds of being satisfied increased by a factor of 3 with higher self-efficacy, greater knee-related quality of life, and returning to the preinjury activity. Conclusions: People who had returned to their preinjury physical activity and who reported higher knee-related self-efficacy and quality of life were more likely to be satisfied with the outcome of ACL reconstruction.
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| 12. |
- Ayeni, O. R., et al.
(author)
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Clinical and Radiographic Criteria Define "Acceptable" Surgical Correction of Hip Femoroacetabular Impingement Syndrome as Well as Postoperative Complications: An International Modified Delphi Study
- 2023
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In: Arthroscopy-the Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 39:5, s. 1198-1210
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Journal article (peer-reviewed)abstract
- Objectives: To develop recommendations for clinical and radiographic criteria to help define the "acceptable" surgical correction of femoroacetabular impingement syndrome (FAIS) and identify/define complications postoperatively. Methods: A 3-phase modified Delphi study was conducted involving a case-based survey; a Likert/multiple choice-based survey concerning radiographic and physical examination characteristics to help define FAIS correction, as well as the prevalence and definition of potential postoperative complications; and 2 consensus meetings. Results: Of the 75 experts invited, 54 completed the Phase I survey, 50 completed the Phase II survey (72% and 67% response rate), and 50 participated in the Phase III consensus meetings. For both typical and atypical (complex) cases, there was consensus that fluoroscopy with multiple views and dynamic hip assessment should be used intraoperatively (96% and 100%, respectively). For typical FAIS cases, the Expert Panel agreed that Dunn lateral and anteroposterior radiographs were the most important radiographs to evaluate the hip postoperatively (88%, consensus). When asked about evaluating the correction of cam impingement postoperatively, 87% voted that they use subjective evaluation of the "sphericity" of the femoral head. In the case of focal and global pincer-type FAIS, there was consensus that the reduction or elimination of the crossover sign (84%) and lateral center-edge angle (91%) were important to inform the extent of the FAIS correction. There was consensus for recommending further investigation at 6 months postoperatively if hip pain had increased/plateaued (92% agreed); that additional investigation and treatment should occur between 6 and 12 months (90% agreed); and that a reoperation may be recommended at 12 months or later following this investigation period (89% agreed). Conclusions: This consensus project identified the importance of using fluoroscopy and dynamic hip assessment intraoperatively; Dunn lateral and anteroposterior view radiographs postoperatively; evaluating the "sphericity" of the femoral head for cam-type correction and the use of dynamic hip assessment; reducing/eliminating the crossover sign for focal pincertype FAIS; evaluating the lateral center-edge angle for global pincer-type FAIS; and avoiding overcorrection of pincer-type FAIS. In cases in which postoperative hip pain increased/plateaued, further investigation and treatment is warranted between 6 and 12 months, and a reoperation may be recommended at a minimum of 12 months depending on the cause of the hip pain. Clinical Relevance: Hip arthroscopy surgeons have yet to reach a firm agreement on what constitutes an "acceptable" or "good" surgery radiographically and how they can achieve desired clinical outcomes. Although this was a comprehensive effort, more study is needed to determine therapeutic thresholds that can be universally applied.
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| 13. |
- Balasingam, Sadeshkumar, et al.
(author)
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Patients With Concomitant Intra-articular Lesions at Index Surgery Deteriorate in Their Knee Injury and Osteoarthritis Outcome Score in the Long Term More Than Patients With Isolated Anterior Cruciate Ligament Rupture: A Study From the Swedish National Anterior Cruciate Ligament Register
- 2018
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In: Arthroscopy. - : W B SAUNDERS CO-ELSEVIER INC. - 0749-8063 .- 1526-3231. ; 34:5, s. 1520-1529
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Journal article (peer-reviewed)abstract
- Purpose: To analyze and compare clinical outcomes after anterior cruciate ligament (ACL) reconstruction 5 and 10 years postsurgery between patients with concomitant intra-articular injuries and those with isolated ACL injury at reconstruction. Methods: Registrations were made using a web-based protocol by physicians for baseline and surgical data. Patients registered their Knee Injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at 5 and 10 years postsurgery. The exclusion criteria for the present study were revisions of previously unregistered ACL surgeries, non-ACL surgeries, patients for whom 10-year follow-up data had not yet been collected, and the proportion of index surgeries that were revision or contralateral interventions. Results: There were 1,295 KOOS scores available for patients 5 years postsurgery, and 1,023 10 years postsurgery from a baseline of 2,751 index reconstructions. A deterioration between the 5-and 10-year scores was observed for patients with concomitant meniscus injury on the KOOS subscales for pain (P = .015), symptoms (P = .005), sport and recreation (P = .011), and knee-related quality of life (QoL) (P = .03) compared with patients with isolated ACL injury. Correspondingly, KOOS subscale score deterioration was seen for combined concomitant cartilage and meniscus injuries for pain (P = .005), symptoms (P = .009), sport and recreation (P = .006), and QoL (P amp;lt; .001). The largest deteriorations were found in sport and recreation (-5.9 points; confidence interval [CI] -10.1, -1.1) and QoL (-6.5 points; CI -10.3, -2.8) subscale scores for patients with concomitant meniscal and cartilage injuries. A similar pattern was not seen between patients with concomitant cartilage injury and isolated ACL injury. Conclusions: The present study reveals that concomitant meniscus injuries at the index operation, either in isolation or in combination with cartilage lesions, render a deterioration of scores on the KOOS outcome subscales for pain, sport and recreation, and quality of life between 5-and 10-year postsurgery follow-up of ACL-reconstructed patients. No such deterioration was seen for patients who had isolated ACL injury.
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| 14. |
- Barclay, C, et al.
(author)
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Medial collateral ligament bursitis in a 12-year-old girl
- 2005
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 21:6, s. 759-
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Journal article (peer-reviewed)
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| 15. |
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| 16. |
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| 17. |
- Cristiani, Riccardo, et al.
(author)
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High Prevalence of Superficial and Deep Medial Collateral Ligament Injuries on Magnetic Resonance Imaging in Patients With Anterior Cruciate Ligament Tears
- 2024
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In: Arthroscopy. - : W B SAUNDERS CO-ELSEVIER INC. - 0749-8063 .- 1526-3231. ; 40:1, s. 103-110
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Journal article (peer-reviewed)abstract
- Purpose: To assess the prevalence of and factors associated with medial collateral ligament (MCL) complex injuries on magnetic resonance imaging (MRI) in patients with anterior cruciate ligament (ACL) tears.Methods: Data were extracted from the Natural Corollaries and Recovery After ACL Injury (NACOX) multicenter longitudinal cohort study. Between May 2016 and October 2018, patients who presented to 1 of 7 health care clinics across Sweden with an ACL tear sustained no more than 6 weeks earlier and who were aged between 15 and 40 years at the time of injury were invited to participate. All the patients included in this study underwent MRI. The mean time from injury to MRI was 19.6 +/- 15.2 days. An orthopaedic surgeon specializing in knee surgery and a musculoskeletal radiologist reviewed all MRI scans. Injuries to the superficial MCL (sMCL), deep MCL (dMCL), and posterior oblique ligament were identified. Stepwise forward multiple binary logistic regression analyses were used to evaluate patient characteristics (age, sex, body mass index, preinjury Tegner activity level, and activity at injury) and injuries on MRI (lateral meniscus [LM] injury, medial meniscus [MM] injury, pivot shift-type bone bruising, medial femoral condyle [MFC] bone bruising, and lateral femoral condyle [LFC] impaction) associated with the presence of MCL complex tears.Results: In total, 254 patients (48.4% male patients) with a mean age of 25.4 +/- 7.1 years were included. The overall prevalence of MCL (sMCL and dMCL) injuries and isolated dMCL injuries was 16.5% (42 of 254) and 24.8% (63 of 254), respectively. No isolated sMCL injuries were found. Posterior oblique ligament injuries were found in 12 patients (4.7%) with MCL (sMCL and dMCL) injuries. An LM injury (odds ratio [OR], 3.94; 95% confidence interval [CI], 1.73-8.94; P = .001) and LFC impaction (OR, 2.37; 95% CI, 1.11-5.07; P = .02) increased the odds of having an MCL injury, whereas an MM injury (OR, 0.26; 95% CI, 0.12-0.59; P = .001) reduced the odds. Isolated dMCL injuries were significantly associated with MFC bone bruising (OR, 4.21; 95% CI, 1.92-9.25; P < .001) and LFC impaction (OR, 3.86; 95% CI, 1.99-7.49; P < .001).Conclusions: The overall combined prevalence of MCL (sMCL and dMCL) injuries and isolated dMCL injuries in patients with ACL tears was high (16.5% + 24.8% = 41.3%). The presence of an LM injury and LFC impaction increased the odds of having an MCL injury, whereas the presence of an MM injury reduced the odds. MFC bone bruising and LFC impaction were associated with the presence of isolated dMCL injuries.Level of Evidence: Level III, retrospective cohort study.
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| 18. |
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| 19. |
- Cristiani, R, et al.
(author)
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Regarding "Editorial Commentary: Meniscal Repair-Why Bother?"
- 2020
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 36:7, s. 1794-1795
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Journal article (other academic/artistic)
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| 20. |
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| 21. |
- de Sa, D., et al.
(author)
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A Comparison of Supine and Lateral Decubitus Positions for Hip Arthroscopy: A Systematic Review of Outcomes and Complications
- 2016
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In: Arthroscopy-the Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 32:4
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Journal article (peer-reviewed)abstract
- Purpose: This systematic review examines outcomes and risk profiles of the hip arthroscopy in the supine versus lateral decubitus positions to elucidate any superiority of one approach over the other. Methods: Three databases (Embase, PubMed, and Medline) were searched for studies that addressed hip arthroscopy performed in either position, and were subsequently screened by two reviewers with data abstracted in duplicate. Results: Similar outcomes were observed. Supine studies showed a greater mean postoperative improvement for modified Harris hip score (33.74), visual analog scale (-3.99), nonarthritic hip score (29.61), Harris hip score (35.73), and hip outcome score (31.4). Lateral decubitus studies showed greater improvement using the Western Ontario and McMaster University Osteoarthritis (14.76) score. Supine studies reported more neuropraxic injuries (2.06% v 0.47%), labral penetration (0.65% v 0%), and heterotopic ossification (0.21% v 0%). Lateral decubitus studies reported more fluid extravasation (0.21% v 0.05%) and missed loose bodies (0.08% v 0.01%). Similar rates of revision (1.8% lateral, 1.4% supine) and conversion to open procedures (2.6% in lateral, 2.0% in supine) were also identified. Conclusions: Because of quality of evidence, direct comparisons are currently limited; however, the supine position is associated with more neuropraxic injuries, labral penetration, and heterotopic ossification, whereas lateral decubitus has increased risk of fluid extravasation and missed loose bodies. At this time, no evidence exists to establish superiority of one position.
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| 22. |
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| 23. |
- Fox, Michael A., et al.
(author)
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Anatomic Anterior Cruciate Ligament Reconstruction
- 2023
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In: Arthroscopy - Journal of Arthroscopic and Related Surgery. - 0749-8063 .- 1526-3231. ; 39:9, s. 1968-1970
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Journal article (peer-reviewed)abstract
- Anterior cruciate ligament reconstruction (ACLR) techniques have substantially evolved over the past several decades, driven by evidence that nonanatomic techniques increase the risk for instability, loss of motion, surgical failure, and posttraumatic osteoarthritis. Early techniques used transtibial femoral tunnel drilling, although improved understanding of the anatomy and biomechanics has led to independent femoral tunnel. Anatomic ACLR requires careful consideration of the native ACL dimensions and orientation. Although there is significant variation between patients, understanding of anatomic patterns allows for reliable identification of the ACL footprints and appropriate tunnel positioning, particularly in chronic injuries where the remanent ACL stump is degraded or absent. The femoral tunnel should be placed low and posterior on the lateral femoral condyle using the lateral intercondylar and bifurcate ridges as landmarks. The center of the tibial footprint can be determined by referencing the medial tibial spine and posterior border of anterior horn of lateral meniscus. Measurement of the dimensions of the native ACL and intercondylar notch is also critical for determining graft size and minimizing the risk of impingement, with a goal of reconstructing 50% to 80% of the tibial footprint area. Clinical outcome studies have demonstrated superior anteroposterior and rotatory knee stability with low surgical revision rates (reported between 3% and 5%). By adhering to the principles of anatomic ACLR, surgeons can produce an appropriately sized and located graft for the individual patient, thereby best restoring native knee kinematics and maximizing function. The aim of this infographic is to highlight essential features of anatomic ACLR techniques, which a focus on the native anatomy and surgical planning to achieve an anatomic ACLR.
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| 24. |
- Grassi, A., et al.
(author)
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Patients With Failed Anterior Cruciate Ligament Reconstruction Have an Increased Posterior Lateral Tibial Plateau Slope: A Case-Controlled Study
- 2019
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In: Arthroscopy-the Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 35:4, s. 1172-1182
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Journal article (peer-reviewed)abstract
- Purpose: To compare knee anatomical parameters of patients with failed anterior cruciate ligament reconstruction (ACL-R) with those of a control group of sex-matched patients with successful ACL-R. Methods: Forty-three patients (34 male, 9 female) who experienced graft failure after ACL-R were enrolled in the failed group. These patients were matched to a control group of 43 patients who underwent primary ACL-R with a minimum follow-up of 24 months. On magnetic resonance imaging, the following parameters were evaluated: transepicondylar distance, lateral and medial femoral condyle widths, tibial plateau width, notch width index, and the ratio of width and height of the femoral notch, ratio between the height and depth of the lateral and medial femoral condyle, lateral and medial posterior tibial slopes, and anterior subluxation of the lateral and medial tibial plateau. Multivariate regression with backward elimination, including only the previously identified significant variables, defined the independent predictors for revision surgery. Results: The anatomical variables that were significantly different between the 2 study groups were lateral and medial posterior tibial slopes, anterior subluxation of the lateral and medial tibial plateau, medial tibial plateau width, lateral tibial plateau width, medial femoral condyle width, and transepicondylar distance; however, the multivariate regression analysis identified the lateral posterior tibial slope (LTPs), the anterior subluxation of the medial tibial plateau, and the medial femoral condyle width as significant independent predictors (P < .05). The LPTs had the highest coefficient and the highest sensitivity (88%) and specificity (84%) to identify failures when considering the optimal cutoff value of 7.4 degrees. Conclusions: Several anatomical parameters have been identified that differ significantly between patients with failed ACL-R and those without a documented failure. The most accurate predictor of ACL failure was an LTPs >7.4 degrees, with a sensitivity of 88% and specificity of 84%. Surgeons should consider measuring LTPs during preoperative assessment of ACL-injured patients, and patients with values >7.4 degrees should be considered at high risk of ACL-R failure.
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| 25. |
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| 26. |
- Hamrin Senorski, Eric, 1989, et al.
(author)
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Preoperative and Intraoperative Predictors of Long-Term Acceptable Knee Function and Osteoarthritis After Anterior Cruciate Ligament Reconstruction: An Analysis Based on 2 Randomized Controlled Trials.
- 2019
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 35:2, s. 489-99
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Journal article (peer-reviewed)abstract
- To determine preoperative predictors of long-term acceptable knee function and the development of osteoarthritis (OA) in long-term follow-up after anterior cruciate ligament (ACL) reconstruction.This study is a long-term follow-up of 2 previous randomized controlled trials that included 193 patients who underwent unilateral ACL reconstruction with ipsilateral hamstring tendon or patellar tendon autografts. Patients who suffered multiligament injuries, major meniscal injuries, chondral lesions requiring surgical treatment, or had a previous ACL reconstruction were excluded. Patient demographics, preoperative clinical assessments, and intraoperative findings were used to create stepwise multivariable regression models to determine the patient-acceptable symptom state (PASS) in the International Knee Documentation Committee and the development of OA defined as a Kellgren-Lawrence grade ≥2. Knee laxity measurements, hop performance, patient-reported outcome, and concomitant injuries were determined as variables.A total of 147 patients (63.7% men) were eligible for inclusion, with a mean follow-up of 16.4 ± 1.3years. The patients were an average age of 27.9 ± 8.3years at the time of ACL reconstruction. One-half of the cohort reported an International Knee Documentation Committee evaluation system score above the PASS cutoff. The presence of a concomitant injury at operation (odds ratio [OR], 2.61; 95% confidence interval [CI], 1.10-6.21; P= .030) and greater preoperative anteroposterior laxity (OR, 1.87; 95% CI, 1.05-3.35; P= .034) increased the likelihood of achieving a PASS. A longer period between ACL injury and reconstruction (OR, 2.25; 95% CI, 1.02-5.00; P= .046) and older age at reconstruction (OR, 2.28; 95% CI, 1.34-3.86; P= .0023) increased the odds of developing OA at follow-up.Patients who were older at the time of ACL reconstruction and had waited >1year between the injury and reconstruction ran an increased risk of having OA 16years after reconstruction. One in 2 patients reported acceptable long-term knee function, but no risk factor for poorer subjective knee function was identified. Patients who had a minor concomitant injury and increased preoperative anteroposterior knee laxity had increased odds of reporting an acceptable long-term knee function.Level II; prospective comparative study.
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| 27. |
- Hurley, Eoghan T., et al.
(author)
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Majority of Studies Show Similar Rates of Return to Play After Arthroscopic Bankart Repair or Latarjet Procedure: A Systematic Review
- 2024
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In: Arthroscopy - Journal of Arthroscopic and Related Surgery. - 0749-8063 .- 1526-3231. ; 40:2, s. 515-522
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Research review (peer-reviewed)abstract
- Purpose: To systematically review the current evidence in the literature to compare return to play following arthroscopic Bankart repair versus open Latarjet procedure for the treatment of anterior shoulder instability. Methods: A literature search was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Comparative studies reporting return to play following arthroscopic Bankart repair versus open Latarjet procedure were included. Return to play was compared, with all statistical analysis performed using Review Manager, Version 5.3. Results: Nine studies with 1,242 patients (mean age: 15-30 years) were included. The rate of return to play was 61% to 94.1% among those undergoing arthroscopic Bankart repair and 72% to 96.8% in those undergoing an open Latarjet procedure. Two studies (Bessiere et al. and Zimmerman et al.) found a significant difference in favor of the Latarjet procedure (P < .05 for both, I2 = 37%). The rate of return to play at preinjury level was 9% to 83.8% among those undergoing arthroscopic Bankart repair and 19.4% to 80.6% in those undergoing an open Latarjet procedure, with no study finding a significant difference (P > .05 for all, I2 = 0%). The mean time of return to play was 5.4 to 7.3 months among those undergoing arthroscopic Bankart repair and 5.5 to 6.2 months in those undergoing an open Latarjet procedure, with no study finding a significant difference (P > .05 for all, I2 = 39%). Conclusions: Overall, the majority of studies showed no significant difference in rates of return to play or timing following arthroscopic Bankart repair or open Latarjet procedure. Furthermore, no study has found a significant difference in rate of return to play at pre-injury level, or rate of return to play among collision athletes. Level of Evidence: III, systematic review of Level I-III studies.
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| 28. |
- Johansson, Anders, et al.
(author)
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Spectroscopic Measurement of Cartilage Thickness in Arthroscopy: Ex Vivo Validation in Human Knee Condyles
- 2012
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In: Arthroscopy. - : WB Saunders. - 0749-8063 .- 1526-3231. ; 28:10, s. 1513-1523
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Journal article (peer-reviewed)abstract
- Purpose: To evaluate the accuracy of articular cartilage thickness measurement when implementing a new technology based on spectroscopic measurement into an arthroscopic camera. Methods: Cartilage thickness was studied by ex vivo arthroscopy at a number of sites (N = 113) in human knee joint osteoarthritic femoral condyles and tibial plateaus, removed from 7 patients undergoing total knee replacement. The arthroscopic image spectral data at each site were used to estimate cartilage thickness. Arthroscopically derived thickness values were compared with reference cartilage thickness as measured by 3 different methods: needle penetration, spiral computed tomography scanning, and geometric measurement after sample slicing. Results: The lowest mean error (0.28 to 0.30 mm) in the regression between arthroscopic and reference cartilage thickness was seen for reference cartilage thickness less than 1.5 mm. Corresponding values for cartilage thickness less than 2.0 and 2.5 mm were 0.32 to 0.40 mm and 0.37 to 0.47 mm, respectively. Cartilage thickness images-created by pixel-by-pixel regression model calculations applied to the arthroscopic images-were derived to demonstrate the clinical use of a camera implementation. Conclusions: On the basis of this investigation on osteoarthritic material, when one is implementing the spectroscopic method for estimating cartilage thickness into an arthroscopic camera, errors in the range of 0.28 to 0.30 mm are expected. This implementation does not, however, influence the fact that the spectral method performs less well in the cartilage thickness region from 1.5 to 2.5 mm and cannot assess cartilage thicker than 2.5 mm. Clinical Relevance: Imaging cartilage thickness directly in the arthroscopic camera video stream could serve as an interesting image tool for in vivo cartilage quality assessment, in connection with cartilage diagnosis, repair, and follow-up.
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| 29. |
- Järvinen, Teppo L. N., et al.
(author)
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Anterior cruciate ligament graft fixation--a myth busted?
- 2010
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In: Arthroscopy. - : Elsevier BV. - 1526-3231. ; 26:5, s. 681-684
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Journal article (peer-reviewed)abstract
- Anterior cruciate ligament graft fixation has become one of the most investigated topics in the sports traumatology literature. With over 400 publications within the past decade, a plausible explanation for the popularity of the topic would be that anterior cruciate ligament graft fixation represents an obvious clinical problem. Yet this does not seem to be the case. We set out to analyze the veracity of the notion that the fixation site is the weak link in a reconstructed knee in the early postoperative period. A mere temporal association is found between the first clinical reports on increased anterior tibial translation relative to the femur with soft-tissue grafts and the first pullout studies reporting lower ultimate failure loads with such grafts. This association was sufficient to convince the orthopaedic community at large that actual causality exists between soft-tissue graft fixation failure and increased knee laxity during healing. Thus the concept of “graft slippage” was born. Even with the imminent risk of being misconstrued as contentious, we submit that the entire concept of graft slippage is a myth, founded on poor scientific practice and affected by commercial bias. As a way forward, clinically important phenomena should be demonstrated through experiments with clear and sound clinical endpoints. As for preclinical studies, although they are indisputably helpful in the elaboration of such phenomena, serious hazards lie in declaring them a sufficient scientific basis for new research or, worse, for clinical standards of care. More importantly, no matter how sophisticated or fascinating their methodology, preclinical studies do not relieve us from the necessity and duty of proving our theories, whenever possible, with randomized controlled trials. Using the search terms “ACL fixation” and “ACL graft fixation,” the Medline literature search results in nearly 600 studies during the last 26 years (1983 to January 2010), of which over 400 have been published within the past decade. As such, anterior cruciate ligament (ACL) graft fixation is among the most investigated topics in recent sports medicine literature.
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| 30. |
- Karikis, Ioannis, 1985, et al.
(author)
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Radiographic Tibial Tunnel Assessment After Anterior Cruciate Ligament Reconstruction Using Hamstring Tendon Autografts and Biocomposite Screws: A Prospective Study With 5-Year Follow-Up
- 2017
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In: Arthroscopy - Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 33, s. 2184-2194
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Journal article (peer-reviewed)abstract
- © 2017 Arthroscopy Association of North America Purpose To radiographically assess the tibial tunnel up to 5 years after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts and biocomposite interference screws. Methods Fifty-one patients underwent anatomic single-bundle ACL reconstruction with metal interference screws in the femur and biocomposite interference screws in the tibia. Standardized digital radiographs with weight-bearing anteroposterior and lateral views of the index knee were taken in the early postoperative period and at 2 and 5 years postoperatively. Of 51 patients, 40 (78%) underwent radiographic assessment on all 3 occasions. Subjective and objective clinical assessments were obtained preoperatively and at the 5-year follow-up. Results The mean follow-up period was 65 months (±3.9 months), with a minimum of 59 months. The width of the tibial tunnel on the anteroposterior view was 9.4 mm (±1.4 mm) in the early postoperative period and 9.2 mm (±1.5 mm) at 5 years (P =.64). The corresponding widths on the lateral view were 9.6 mm (±1.5 mm) in the early postoperative pe riod and 9.0 mm (±1.4 mm) at 5 years (P =.014). In 33 of 40 patients (83%) the width of the tibial tunnel had decreased on 1 or both views at 5 years compared with the early postoperative period. The study group had improved significantly at the 5-year follow-up compared with the preoperative assessments in terms of the KT-1000 arthrometer laxity tests (MEDmetric, San Diego, CA), pivot-shift test, Tegner activity scale, and Lysholm knee score (P < .001). No correlations were found between the tunnel widths and the KT-1000 assessment. Conclusions In 83% of patients, the width of the tibial tunnel had decreased on 1 or both radiographic views at 5 years compared with the early postoperative period after ACL reconstruction using biocomposite interference screws. Level of Evidence Level II, prospective study.
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| 31. |
- Karikis, Ioannis, 1985, et al.
(author)
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The Long-Term Outcome After Early and Late Anterior Cruciate Ligament Reconstruction.
- 2018
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 34:6, s. 1907-1917
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Journal article (peer-reviewed)abstract
- To compare long-term clinical and radiographic outcomes in patients undergoing either early (group A) or late (group B) surgery after anterior cruciate ligament (ACL) injury.ACL reconstruction using hamstring tendon autografts was performed in 30 patients in group A (median age, 23years; range, 17-49years) and 31 patients in group B (median age, 27years; range, 17-38years). The patients in group A were operated on within 5months (median, 3months; range, 2-5months) of injury, whereas those in group B were operated on more than 24months (median, 30months; range, 24-48months) after injury. The follow-up period was 10years (median, 117months [range, 77-222months] in group A and 129months [range, 77-206months] in group B; P= .44). Multiple objective clinical evaluation tests and patient-reported outcome measures were obtained preoperatively and at follow-up. At follow-up, radiographic assessments of knee osteoarthritis (OA) bilaterally were performed.The frequency of meniscectomy at the index operation was significantly lower in group A (20%) than in group B (52%) (P= .01). There were no significant differences between the groups in terms of Tegner and Lysholm scores and laxity tests both preoperatively and at follow-up. Both groups improved over time in terms of Tegner and Lysholm scores (P < .05). At follow-up, significantly more medial-compartment OA in the index knee was found in group B than in group A (P= .037) according to the Ahlbäck classification system. The index knee showed significantly more OA than the contralateral knee in both groups (P< .01).Patients who underwent early ACL reconstruction required significantly fewer meniscectomies at the index operation than patients who underwent late reconstruction and showed significantly less OA on the medial side of the knee 10years after reconstruction. However, no significant differences were found between the groups in terms of clinical assessments.Level III, retrospective comparative study.
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| 32. |
- Karlsson, Jón, 1953, et al.
(author)
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A practical guide to research: design, execution, and publication.
- 2011
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 27:4 Suppl
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Journal article (peer-reviewed)
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| 33. |
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| 34. |
- Kartus, Jüri, 1955, et al.
(author)
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Invention Versus Gold Standard: A Hands-On Research Pearl on Study Design and Statistical Concerns
- 2018
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In: Arthroscopy - Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 34:12, s. 3266-3270
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Journal article (peer-reviewed)abstract
- This article points out what is important to consider when planning to perform and analyze a commonly seen study involving a comparison of an innovation with something established. A hands-on guide on how to perform this type of research trial and how to choose proper statistical methods is given. © 2018 Arthroscopy Association of North America
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| 35. |
- Kvist, Joanna, et al.
(author)
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Results From the Swedish National Anterior Cruciate Ligament Register.
- 2014
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231 .- 0749-8063. ; 30:7, s. 803-810
-
Journal article (peer-reviewed)abstract
- The purpose of the study was to analyze the baseline variables and clinical outcomes for almost 24,000 patients entered into the Swedish National ACL Register between January 2005 and December 2012.
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| 36. |
- Laxdal, Gauti, 1966, et al.
(author)
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Outcome and risk factors after anterior cruciate ligament reconstruction: a follow-up study of 948 patients
- 2005
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In: Arthroscopy. - : Elsevier BV. - 1526-3231. ; 21:8, s. 958-964
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim of the study was to assess the outcome and risk factors after anterior cruciate ligament (ACL) reconstruction in a large group of patients. TYPE OF STUDY: Case series. METHODS: Included in this retrospective study were 948 patients (323 female, 625 male) with a symptomatic unilateral ACL rupture, who underwent arthroscopic reconstruction using patellar tendon autograft and interference screw fixation at 3 Swedish hospitals. The median age of the patients at the time of the index operation was 26 years (range, 14 to 53 years). The patients underwent surgery at a median of 12 months (range, 0.5 to 360 months) after their injury. Independent physiotherapists performed the follow-up examinations at a median of 32 months (range, 21 to 117 months) postoperatively. RESULTS: Of the 948 patients, 550 (58%) underwent meniscal surgery before, during, or after the ACL reconstruction. The median Tegner activity level was 8 (range, 2-10) before injury, 3 (range, 0-9) preoperatively, and 6 (range, 1-10) at follow-up (P < .0001 preoperative v follow-up). At follow-up, the median Lysholm score was 90 points (range, 14-100), the median KT-1000 anterior side-to-side laxity difference was 1.5 mm (range, -6 to 13 mm), and the median 1-leg hop test quotient was 95% (0% to 167%) compared with the contralateral normal side. At follow-up, 69.3% of the patients were classified as normal or nearly normal according to the International Knee Documentation Committee evaluation system. However, 36% of the patients were unable to or had severe problems performing the knee-walking test. Inferior results correlated with increased time period between the index injury and reconstruction and concomitant joint damage found at the index operation. CONCLUSIONS: Overall, the results were good after ACL reconstruction using patellar tendon autograft and interference screw fixation. Concomitant joint damage and a long time period between the injury and reconstruction are major risk factors for inferior outcome after ACL reconstruction. LEVEL OF EVIDENCE: Level IV, case series.
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| 37. |
- Marx, R. G., et al.
(author)
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Clinical decision making based on evidence
- 2009
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In: Arthroscopy: The Journal of Arthroscopic & Related Surgery. - : Elsevier BV. - 0749-8063. ; 25:3
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Journal article (other academic/artistic)
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| 38. |
- Memon, M., et al.
(author)
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Arthroscopic Management of Septic Arthritis of the Native Shoulder: A Systematic Review
- 2018
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In: Arthroscopy-the Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 34:2
-
Journal article (peer-reviewed)abstract
- Purpose: To investigate arthroscopic management of native shoulder joint septic arthritis-specifically, indications, patient outcomes, and complications. Methods: PubMed, MEDLINE, and Embase were used to search the literature, and data abstraction was performed independently and in duplicate. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist guided reporting and data abstraction. The quality of all included studies was assessed with the Methodological Index for Non-randomized Studies (MINORS) criteria. The results are presented in a narrative summary fashion using descriptive statistics including means, proportions, ranges, kappa values, and intraclass correlation coefficient values. Results: Overall, 27 studies (19 case reports and 8 case series) were identified, including 115 patients (121 shoulders). The mean follow-up period was 29.1 months (range, 1-199 months). The indications for shoulder arthroscopy owing to infection included pain; limited range of motion; swelling, erythema, and tenderness; fever; elevated leukocyte count, erythrocyte sedimentation rate, and/or C-reactive protein level; synovial aspirate findings; and/or imaging findings. Overall, 46 patients (40%) achieved infection eradication and functional improvement after a single arthroscopic procedure. However, 43 patients (37%) had ongoing symptoms or complications, including 32 (30%) who required revision arthroscopic procedures, 7 (6%) who underwent open arthrotomy for septic arthritis management, 2 (2%) in whom avascular necrosis of the humeral head developed, 1 (1%) in whom adhesive capsulitis developed, and 1 (1%) in whom an irregular profile of the humeral epiphysis developed on plain radiographs. Conclusions: Arthroscopic management of native shoulder septic arthritis can yield alleviation of pain and a return to full range of motion, daily activities, and sports. However, there is a high reoperation rate, which may correlate with poor patient prognostic factors. This systematic review did not show the superiority of either arthroscopic surgery or open arthrotomy for the management of shoulder septic arthritis.
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| 39. |
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| 40. |
- Odenbring, Sten, et al.
(author)
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Long-term Outcomes of Arthroscopic Acromioplasty for Chronic Shoulder Impingement Syndrome: A Prospective Cohort Study With a Minimum of 12 Years' Follow-up
- 2008
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In: Arthroscopy. - : Elsevier BV. - 0749-8063. ; 24:10, s. 1092-1098
-
Journal article (peer-reviewed)abstract
- Purpose: The Purpose of this Study was to evaluate long-term outcomes of arthroscopic acromioplasty for shoulder impingement syndrome. Methods: This was a prospective cohort study of 31 shoulders (24 men) that underwent arthroscopic acromioplasty for shoulder impingement syndrome during 1992 and 1993. The mean age at surgery was 49 years (range, 33 to 68 years). A group of 29 shoulders (22 men) operated on consecutively with open acromioplasty from 1985 through 1991 served as controls. The patients were evaluated with the University of California, Los Angeles (UCLA) score (range, 0 to 35 points) at baseline and at 2 follow-up times performed at a mean of I and 13 years after surgery, respectively. At the second follow-up, the Disabilities of the Arm. Shoulder and Hand score, the Short Form-36 bodily pain score, and the EQ-5D health utility index also were obtained. Results: After arthroscopic acromioplasty, the mean improvement in UCLA score from baseline to long-term follow-up was 13 points (95% confidence interval, 11 to 15 points), and the scores indicated an excellent or good result in 77% of shoulders. The mean UCLA score was 32 points (SD, 5 points) for the patients treated with arthroscopic acromioplasty and 28 points (SD, 8 points) for those treated with open acromioplasty; the mean difference was 4.3 points (95% confidence interval, 0.4 to 8.2 points P = .03). In a mixed-model analysis adjusting for age. sex, duration of symptoms, preoperative UCLA score, dominance of operated side. rotator Cuff status at surgery, and time since surgery, the rate of change from baseline in UCLA score over time was significantly better after arthroscopic surgery than after open Surgery. Conclusions: Good results of arthroscopic acromioplasty were maintained at 12 to 14 years after surgery with excellent or good results shown in 77% of shoulders, and the long-term outcomes were superior to those after open acromioplasty. Level of Evidence: Level III, therapeutic case-control study.
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| 41. |
- Piussi, R., et al.
(author)
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Greater Psychological Readiness to Return to Sport, as Well as Greater Present and Future Knee-Related Self-Efficacy, Can Increase the Risk for an Anterior Cruciate Ligament Re-Rupture: A Matched Cohort Study
- 2022
-
In: Arthroscopy - Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063. ; 38:4
-
Journal article (peer-reviewed)abstract
- Purpose: To determine the psychological characteristics and strength outcomes of patients who sustained an early anterior cruciate ligament (ACL) re-rupture after their primary ACL reconstruction and cross-sectionally compare them with a matched cohort of patients who did not sustain a reinjury during the first 2 years after primary ACL reconstruction. Methods: In this matched cohort study, data for quadriceps and hamstring strength and 3 hop tests and answers to standardized patient-reported outcomes (the Anterior Cruciate Ligament Return to Sport after Injury scale and a short version of the Knee Self-Efficacy Scale) were extracted from a rehabilitation outcome registry. Data for patients suffering a re-rupture were extracted, and patients were matched in terms of sex, age, and activity level with patients not suffering an ACL re-rupture within 2 years of primary reconstruction. The groups were compared 10 weeks and 4, 8, and 12 months after the primary reconstruction. Results: A total of 36 patients suffering an ACL re-rupture were matched with 108 patients not suffering a re-rupture after ACL reconstruction. Patients who suffered an ACL re-rupture had greater psychological readiness, that is, greater confidence in performance, lesser negative emotions, and lesser risk appraisal, to return to sport (RTS) at 8 months (81.2 vs 67.9 [95% Δconfidence interval {CI} 2.7-23.8) P = .014) and at 12 months (95.2 vs 67.1, (95% ΔCI 14.3-41.8) P ≤ .001), and greater knee-related self-efficacy at 8 months (8.6 vs 8.0 [95% ΔCI 0.1-1.2], P = .021) and 12 months (9.4 vs 8.1, [95% ΔCI 0.3-2.2] P = .012) after primary ACL reconstruction, compared with the matched group. Conclusions: A stronger psychological profile, defined by a greater psychological readiness to RTS and knee-related self-efficacy, may be associated with an ACL re-rupture within 2 years of the primary reconstruction. Level of Evidence: Matched cohort study, level III. © 2021 The Author(s).
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| 42. |
- Roos, Ewa M., et al.
(author)
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Substantial disability 3 months after arthroscopic partial meniscectomy: : A prospective study of patient-relevant outcomes
- 2000
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In: Arthroscopy. - : Elsevier BV. - 0749-8063. ; 16:6, s. 619-626
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Journal article (peer-reviewed)abstract
- To our knowledge, this is the first prospective study using validated questionnaires to assess patient-relevant outcomes after arthroscopic partial meniscectomy. Data from the Knee Injury and Osteoarthritis Outcome Score (KOOS), the SF-36 Medical Outcomes Study Short-Form Health Survey, and the Lysholm Knee Scoring Scale were available for 74 consecutive patients (50 males, 24 females; mean age, 45 years) with isolated meniscus tear (n = 47) or meniscus tear combined with cartilage damage (n = 27). At postoperative follow-up (mean, 14.4 weeks) significant improvement was seen, but despite only minor pain and other symptoms postoperatively, significant physical disability and handicap were reported. Postoperatively, 30% of patients were active in sports compared with 63% before injury. A sedentary lifestyle was reported by 38% compared with 9% before injury. We conclude that patient-relevant outcomes provide additional information and should be assessed after arthroscopic partial meniscectomy. We further suggest that preoperative information for the meniscectomy patient should include a realistic expected functional outcome.
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| 43. |
- Samuelsson, Kristian, 1977, et al.
(author)
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Treatment of anterior cruciate ligament injuries with special reference to graft type and surgical technique: an assessment of randomized controlled trials.
- 2009
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 25:10, s. 1139-74
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Journal article (peer-reviewed)abstract
- The primary aim was to summarize and assess current evidence from randomized controlled trials (RCTs) on anterior cruciate ligament injuries, with special reference to graft type and surgical technique. The secondary aims were to identify the relative strengths and weaknesses of the selected studies, to resolve contradictions in the literature, and to evaluate the need for further studies.
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| 44. |
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| 45. |
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| 46. |
- Schollin-Borg, Maria, et al.
(author)
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Presentation, outcome, and cause of septic arthritis after anterior cruciate ligament reconstruction : a case control study
- 2003
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In: Arthroscopy. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 19:9, s. 941-7
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Journal article (peer-reviewed)abstract
- PURPOSE: The objective of this study was to examine clinical presentation and medium-term outcome of patients with septic arthritis of the knee after anterior cruciate ligament (ACL) reconstruction. TYPE OF STUDY: Matched case control study. METHODS: From a consecutive case series of 575 patients who underwent ACL reconstruction from 1996 through 1999, we report on 10 patients (1.7%) with postoperative septic arthritis. These patients were compared with individually matched patients without infection, on average, 3 years after surgery. The examination included physical and radiographic evaluation, functional testing, KT-1000, Lysholm and Tegner scales, and the International Knee Documentation Committee (IKDC) and Knee Injury and Osteoarthritis Outcome Score (KOOS) form. RESULTS: The predominant clinical presentation among patients with septic arthritis was modest classic signs of local infection. However, all had fever and elevated sedimentation rate or high C-reactive protein. Bacterial cultures showed coagulase-negative Staphylococcus species in 6, Staphylococcus aureus in 1, and Propionibacteriaceae species in 1 patient. The diagnosis was established with a delay of approximately 5 days. All patients underwent arthroscopic debridement and lavage (2 cases) or continuous irrigation (8 cases), as well as antibiotic treatment. One experienced graft rupture caused by the infection. At the end of the follow-up evaluation, the infected patients reported significantly lower activity levels than the control subjects (mean Tegner score, 5.3 v 7.2, P =.03). No statistically significant differences were noted in mean Lysholm, IKDC, or KOOS scores, or in KT-1000 difference. Two infected patients scored lower on the Tegner and Lysholm scales postoperatively than they did preoperatively. When examining the causes of infection, we found contamination by coagulase-negative Staphylococcus on supposedly sterile suture clamps on 3 graft preparation boards. CONCLUSIONS: In cases of suspected septic arthritis after ACL reconstruction, laboratory studies and aspiration followed by culture testing should be performed liberally to avoid the otherwise frequently delayed diagnosis. The inferior postoperative activity level noted in infected patients appeared not to be secondary to graft failure but may be related to arthrofibrosis, cartilage damage, or recurring postinfectious meniscal tears.
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| 47. |
- Slaven, Sean E., et al.
(author)
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Revision Arthroscopic Bankart Repair Results in High Failure Rates and a Low Return to Duty Rate Without Recurrent Instability
- 2023
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In: ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 39:4, s. 913-918
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Journal article (peer-reviewed)abstract
- Purpose: The purpose of this study was to determine, in a military population without critical bone loss, the rate of recurrent instability after revision arthroscopic stabilization for failed primary arthroscopic Bankart repair. Methods: Fortyone revision arthroscopic stabilizations were performed at a single military institution between 2005 to 2016 for recurrent anterior shoulder instability after primary arthroscopic Bankart repair. Minimum follow-up was 2 years, and shoulders with glenoid bone loss >20% were excluded. The primary outcome of interest was the incidence of failure, defined by recurrent instability. Results: Age at revision surgery averaged 22.9 +/- 4.3 years, and 88% were either service academy cadets or active duty combat arms soldiers. Mean follow-up was 7.8 years. Twenty-three patients (56%) returned to duty without recurrent instability after revision arthroscopic stabilization. Eighteen patients (44%) experienced recurrent instability after return to duty. Glenoid bone loss averaged 6.2% (95% confidence interval [CI], 3.2%-9.2%) in the successful group and 5.7% (95% CI, 3.1%-8.3%) in the failure group (P = .808). Conclusions: Revision arthroscopic stabilization of failed primary arthroscopic Bankart repair has a failure rate of 44% in a young military population. The similar amounts of bone loss between groups indicates that bone loss is not the primary determinant of failure in revision arthroscopic stabilization.
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| 48. |
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| 49. |
- Stener, Sven, 1953, et al.
(author)
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Anterior cruciate ligament reconstruction reduces bonemineral areal mass.
- 2013
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In: Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association. - : Elsevier BV. - 1526-3231. ; 29:11, s. 1788-95
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Journal article (peer-reviewed)abstract
- The aim of this study was to prospectively follow bone mineral areal mass (BMA) changes in the calcaneii, hips,and lumbar spine after anterior cruciate ligament (ACL) reconstruction using hamstring tendon autografts.
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| 50. |
- Sundemo, David, et al.
(author)
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Editorial Commentary: Diagnosis and Treatment of Generalized Joint Hypermobility in Patients With Anterior Cruciate Ligament Injury
- 2021
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In: Arthroscopy - Journal of Arthroscopic and Related Surgery. - : Elsevier BV. - 0749-8063 .- 1526-3231. ; 37:7, s. 2348-2350
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Journal article (other academic/artistic)abstract
- Generalized joint hypermobility (GJH), or laxity, is defined as hyperextensibility of the synovial joints. Hypermobility is caused by alterations in the connective tissues, in turn caused by various factors including impaired function of collagen proteins. For measurement of knee GJH, we highly recommend using the Beighton score, the most frequently used method in both the sports medicine and other literature. Our recommendations on how to treat patients with anterior cruciate ligament (ACL) injury with generalized joint hypermobility include the following: (1) use patellar-tendon or quadriceps tendon autograft for ACL reconstruction; (2) always consider performing a lateral extra-articular tenodesis; and (3) make sure patients pass a return to sport test battery including strength, hop performance, subjective knee function, and movement quality. Delay to return to sport may be as long as 1 year after surgery.
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