bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedicine for obstructive sleep apnea syndrome: An updated review
Authors: Zhu Rongchang , Peng Ling , Liu Jiaxin , Jia Xinyu
Published: October 2024

Telemedicine (TM) is a new medical service model in which computer, communication, and medical technologies and equipment are used to provide “face-to-face” communication between medical personnel and patients through the integrated transmission of data, voice, images, and video. This model has been increasingly applied to the management of patients with sleep disorders, including those with obstructive sleep apnea syndrome (OSAS). TM technology plays an important role in condition monitoring, treatment compliance, and management of OSAS cases. Herein, we review the concept of TM, its application to OSAS, and the related effects and present relevant application suggestions and strategies, which may provide concepts and references for OSAS-related TM development and application.
The i-CanManage program to improve exercise and symptom management for Vietnamese women after cancer: A pilot randomized controlled trial protocol
Authors: Hoa Nguyen Huyen Thi , Bui Linh Khanh , Tran Tran Ngoc , Thuy Nguyen Ngan Thi , Phuong Anh Hoang , Pham Hieu Huy , Taylor-Robinson Andrew W , Duc Tran Quang , Thanh Nguyen Huong Thi
Published: October 2024

Background

Women dealing with cancer often face a myriad of physical and psychological challenges. Regular physical activity and mobile applications offering healthcare consultation, information, and health tracking have shown promise in aiding this demographic. Therefore, this study aims to examine the effectiveness of the i-CanManage program in improving physical activity, self-efficacy in symptom management, and the quality of life (QoL) among Vietnamese women after completion of cancer treatment.

Methods

A two-arm pilot randomized controlled trial will be conducted. Eligible participants will be randomly allocated to intervention and control groups. Members of both groups will be provided with a Cancer Management Handbook containing information on Life After Cancer and Symptom Management. Intervention group participants will be offered a 12-week personalized exercise program called i-CanManage via a Cancer Wellness Program smart application—an artificial intelligence-based mobile app developed for monitoring patients’ symptoms with a Fitbit Charge 5 wearable device. Data will then be collected at weeks 0, 6, and 12 concerning physical activity, symptom severity, self-efficacy, self-care, and QoL. App usability and user experience will also be explored using both quantitative and qualitative methods.

Discussion

This pilot study will assess the effectiveness of the internet-based cancer management program on physical activity, self-efficacy in symptom management, and QoL of women following cancer treatment in Vietnam, as well as evaluate users’ experience with the smart app. The findings will contribute to the growing evidence on the role of mhealth in oncology care, providing insights into how technology-driven interventions can empower patients in their cancer recovery journey. Datasets collected from this study will be openly available to the research community to foster new advances in the field.
A Comparative Study of High School Junior and Senior Students’ Social Presence, Flow and Technological Acceptance in Distance English Learning: A Mixed-Methods Perspective
Authors: Zhou Sijing , Zhou Yu
Published: October 2024

Prior research on online language learning is extensive but mainly focused on higher education setting. However, secondary school learners’ distance learning experiences and psychological profile have been largely neglected due to the fact that teenagers are rarely involved in distance learning. This situation has changed with schools moving their classrooms online in a time of crisis during COVID-19. To address this issue, this study adopts a mixed-methods research design to investigate Chinese EFL (English-as-a-foreign-language) learners’ virtual experience in distance English learning, based on theories of positive psychology and technology acceptance model (TAM). Participants were 323 students from junior high schools and 398 students from senior high schools in China. Data were collected by both questionnaires and interviews. Quantitative results from independent samples t-tests and structural equation modeling (SEM) indicate that, first, junior high school students reported a significantly more positive perception than senior sample in all six measured constructs. Second, the predictive effects of social presence and flow on technology acceptance were broadly confirmed in both groups. Qualitative analysis reveals that learners had complex and multifaceted perceptions, highlighting the two-sided nature of distance English learning: technology can be both facilitating and challenging. This study aims at exploring the factors influencing learners’ acceptance of online English learning, providing ideas for optimizing the online learning environment, and maximizing the benefits and potential of online English learning.
A Study on the Evaluation of Science and Technology Innovation Competitiveness of National Center Cities in China
Authors: Sun Zhihua
Published: October 2024

The purpose of this paper is to assess the competitiveness of science and technology innovation (STI) in national center cities in China (NCCC), identify the factors that limit their STI competitiveness, and propose ways to enhance their competitiveness. Firstly, a four-level evaluation index system is created by selecting 13 elements and 60 indicators from five STI dimensions: foundation, environment, input, output, and performance. Then, we use entropy-weighted TOPSIS, systematic cluster analysis, and geo-detector to conduct a comprehensive evaluation and cluster comparison analysis in the dimensions of time and space, and identify the driving forces and interactions. Our study reveals significant differences in the STI competitiveness of the nine NCCCs and their five subsystems. It also shows that the STI competitiveness of the old first-tier NCCCs in the developed regions of eastern China is generally higher than that of the new first-tier NCCCs in the less developed regions of central and western China. The suggestions proposed in this paper, such as enhancing the “head-wolf effect,” following the “city-by-city approach,” and promoting synergistic development, will not only help the NCCCs to become top-notch global STI centers but also serve as a reference for cities in other countries seeking to boost their STI competitiveness.
Self-Monitoring Foci, Speed, and the Relationship with Pausing Behavior in an EFL Context
Authors: Albarqi Ghadah
Published: October 2024

Self-monitoring—the ability to detect and correct errors during speech production plays an important role in second language production. Despite its importance, it has received little attention within English as a Foreign Language (EFL) contexts, particularly with regard to self-monitoring foci, speed, and its association with pausing behavior. This study aims to contribute to this area by investigating self-monitoring foci, speed, and the relationship between self-repair and pausing behavior within an EFL context. Sixty six EFL learners were recruited to perform picture-based description tasks. The research employed repeated measures and correlation analysis to address the research questions. The findings revealed that EFL learners frequently made more grammatical repairs compared to other repair types. Grammatical repair also took significantly longer to process than other repair types, implying that Grammatical repair might be challenging for EFL learners. Furthermore, the findings revealed a weak negative correlation between the frequency of Grammatical repair and pauses between clauses, suggesting that between-clause pauses in EFL speech might be associated with self-monitoring process. These insights shed light on the psycholinguistic aspects of self-monitoring in EFL contexts, carrying significant implications for research and theory.
Travel Choices and Perceived Images Influenced by AI Interactive Approaches of Travel Apps: An Evidence From Chinese Mobile Travel Users
Authors: Luo Tianyang , Mohamed Ahmad Edwin , Yusof Noor Suhaila
Published: October 2024

The main objective of this article is to investigate how the AI interactive approaches of travel apps affect tourists’ travel choices directly or indirectly through perceived images, in order to further understand whether tourists can have a favorable user experience in the face of this non-human service, and whether the interactive approaches should be adapted to satisfy the marketing intentions set by the travel app in response to the competitive strength in the marketplace. The research methodology uses quantitative analysis, hypotheses supported by a theoretical background and the formation of a research model, the collection of basic data through questionnaires, and data analysis using structural equation modeling with Amos 22.0. The major findings are associated with the essential role of the interactive approaches (including informativeness, playfulness, and personalization approaches) offered by the travel apps on both the users’ perceived images and travel choices. This not only emphasizes the role of AI interactive approaches in the experiential travel assistance provided to users, but also represents a stronger marketing element to the destination perceived image composition and travel decisions of tourists. The findings also support the development of approaches for human-android interaction and tourism marketing with AI as the main service. This research has the scientific value of an integrated disciplinary analysis that combines theories from computer technology, tourism management, and psychology.
Predictors of Mobile Payment Use Applications from the Extended Technology Acceptance Model: Does Self-Efficacy and Trust Matter?
Authors: Tian Yang , Chan Tak Jie
Published: October 2024

With the development of the global economy, there is growing attention to mobile payment. However, the attention on mobile payment was mainly focused on developed context, while research in developing context is still at an early stage. In recent years, mobile payments have decisive influence on the financial transactions of consumers all over the world. This research seeks to look into the predictors affecting the adoption of mobile payments through the extended Technology Acceptance Model (TAM) which incorporates perceived quality, self-efficacy, and trust as additional predictors. Survey questionnaires were spread and 371 valid feedbacks were received from consumers in Malaysia who have experience using mobile payment. Structural equation modeling was utilized via the SmartPLS for processing data analysis. The results showed that the behavioral intention of Malaysian consumers was significantly predicted by perceived usefulness, perceived ease of use, and perceived quality, while the behavioral intention was found to positively influence the use behavior of mobile payment. In addition, trust was confirmed to significantly moderate the relationship between behavioral intention and use behavior. However, the moderating effect of self-efficacy was not ascertained. The results served as a reference for FinTech service companies to develop mobile payment platforms in the future and contribute to the technology marketing scholarship.
Research Trends and Patterns on International Migration of Health Workers (1950–2022)
Authors: Sweileh Waleed
Published: October 2024

In the context of globalization and liberalization, the international migration of health workers has gained prominence due to increased cross-border mobility. This migration trend, impacting healthcare systems, has intensified recently, driven by factors like the COVID-19 pandemic and demand in high-income countries. The present study was designed to give an overview on research trends and patterns of scholarly production on this topic. Relevant documents published in Scopus from 1950 to 2022 were extracted and analyzed using bibliometric methods. The search string extracted 708 articles. The Human Resources for Health journal ranked first while the University of Sydney was the leading institution. Authors from the US contributed the most (25.8%), followed by the UK, Canada, and Australia. At the regional level, countries in the WHO South-Eastern Asian region and WHO Eastern Mediterranean region contributed the least. Cross-country research collaboration was limited. The research hotspots that attracted the attention of scholars were nurse and physician migration, policy implications, and impact on developing countries. Emerging research topics were the impact of COVID-19 on migration and identification of push-pull factors. Most frequently mentioned push factors driving health worker migration included economic disparities, unfavorable work conditions, and security concerns. Conversely, the main pull factors encompassed prospects of advanced training, better quality of life, and enhanced practice environments. Future research should focus on global policies and push-pull factors to restore the balance in the ratio of health workforce between high and low- and middle-income countries.
Association of Anterior Knee Pain With Extension Deficit After Anterior Cruciate Ligament Reconstruction: A Systematic Review
Authors: Georgoulis Jim D. , Savvidou Olga D. , Patras Kostas , Melissaridou Dimitra , Hadjimichael Argyris C. , Papagelopoulos Panayiotis J. , Georgoulis Anastasios D.
Published: October 2024

Background:

Previous systematic reviews have reported the incidence of anterior knee pain (AKP) and extension deficit (ED) after anterior cruciate ligament reconstruction (ACLR); however, both outcomes are estimated separately and thus are assumed to be uncorrelated.

Purpose:

To estimate whether there is a clinically relevant association between the population effects of ED and AKP after ACLR.

Study Design:

Systematic review; Level of evidence, 2.

Methods:

Under PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review was conducted by searching PubMed, EMBASE, and the Cochrane Library electronic databases for published articles reporting incidence of both AKP and ED after ACLR with either bone–patellar tendon–bone (BPTB) or hamstring (HS) graft that returned 298 studies after the initial search. A Bayesian hierarchical measurement error model estimated the population effect of ED and AKP.

Results:

Twelve publications involving 976 patients (mean follow-up, 77.9 months; range, 24-180 months) were included in the systematic review. There was a clear, moderate correlation between population ED and population AKP for the BPTB ( r = 0.40; 95% CI, 0.39-0.42) and the HS grafts ( r = 0.35; 95% CI, 0.33-0.36). Model expected estimates for the population effects of AKP and ED were 24.1% (95% CI, 17.4%-31.9%) and 17.5% (95% CI, 10.6%-25.0%), respectively, for the BPTB graft and 16.1% (95% CI, 9.2%-23.9%) and 13.1% ED (95% CI, 6.0%-20.8%) for the HS graft, respectively. The posterior mean difference in AKP between BPTB and HS grafts was clear and substantial (8.3% [95% CI, 0.3% to 16.1%]); there was no substantial difference in the posterior mean difference of ED between BPTB and HS grafts (4.3% [95% CI, –3.8% to 13.0%).

Conclusion:

Our systematic review demonstrated a moderate but clear correlation between ED and AKP irrespective of graft type. From a clinical perspective, this association emphasizes the need for intraoperative achievement of full extension and avoidance of situations that may cause ED. The higher incidence of AKP in patients with BPTB graft may also be attributed to factors related to the graft harvest site. Future metaregression analyses could investigate whether additional factors such as follow-up duration or rehabilitation protocols can moderate the association between AKP and ED after ACLR with either BPTB or HS graft.
Secretome for Cartilage Problems: Is the Current State Enough?
Authors: Utomo Dwikora Novembri
Published: October 2024

As the old paradigm of cell-based cartilage treatment has shifted to promising cell-free therapy, the role of secretome has been more profound. To provide the best environment for cartilage regeneration is to provide the most optimum condition and composition of the secretome which has to be more chondrogenic. The currently available crude secretome does not specifically provide the necessary condition for cartilage. This topic will discuss the three most recent advancements to improve the efficacy and reliability of the secretome. The first is to yield a secretome with more chondrogenic properties that can be harvested from a novel three-dimensional cell culture using a bovine cartilage scaffold as culture medium. One of the pearls of secretome is the availability for transport and storage. Therefore, freeze-drying the secretome can be seen to improve stability for transport and storage. Lastly, this secretome must be applicable in cartilage problems. An animal study has been conducted to prove the efficacy of this secretome in osteoarthritis model. Histological evaluation shows promising changes after the application.
Rotator cuff problem of the hip
Authors: Reksoprodjo Adisa Yusuf
Published: October 2024

Rotator cuff tear of the hip is a term coined by Kagan et al in 1999 to describe torn tendon on the abductors of the hip, Gluteus medius and Gluteus minimus. Beside this term, several terms existed to further complicate the research on these topics and, at the same time, highlight the problem at this particular anatomic site, the trochanteric area. The problem mainly lies in the integrity of those two tendons, and recent developments in hip preservation surgery also show that it is also possible to address this problems using an endoscopic approach with comparable outcome to an open approach, akin to its counterpart on the shoulder. One must exercise vigilance to notice the pathology in this area and systematically narrow down the differential diagnosis before deciding whether to go with conservative or operative treatment. Pain in the side accompanied by coronal plane weakness, with good observation of the structures involved, could show the problem. Good conservative treatment is usually the first choice, but in cases of obvious tears, repair, whether open or endoscopic, is recommended. Good post-op management is mandatory to achieve satisfactory results.
Peroneal Tendon Dislocation
Authors: Lim Evan
Published: October 2024

Peroneal tendon dislocation is one of the main causes of lateral ankle pain and instability. This injury is frequently misdiagnosed as a lateral ankle sprain usually in young and active patients. The most common mechanism of injury is a violent dorsiflexion with eversion or inversion in a dorsiflexed ankle. Patients may present with chronic instability, lateral sided ankle pain, ankle stiffness, and snapping. It often occurs among soccer, skiing, rugby, horse riding, and biking that results in ankle twisting. Proper history and clinical assessment such as Sobel Test are mandatory, but magnetic resonance imaging and dynamic ultrasound has been recognized to be the most accurate tool for diagnosing peroneal tendon dislocation. There are anatomical predisposing factors that lead to peroneal tendon dislocation such as the absence of SPR (Superior Peroneal Retinaculum), lateral ankle laxity, and shallow retro malleolar groove. Peroneal tendon dislocations occur mainly because of secondary disruption of the SPR from it’s insertion along the posterolateral margin of the fibula with or without it displacement of the associated fibrocartilaginous ridge. Treatment of this injury is cased of certain things like the timing of the injury and the activity level of the patient. No specific approach has been proven superior for peroneal tendon relocation surgical methods. Five different surgical methods are anatomic reattachment of the retinaculum, reinforcement of the SPR with local tissue transfers, rerouting the tendons behind the calcaneofibular ligament, bone block procedures, and groove deepening procedures. These procedures resulted in excellent outcomes, low recurrence rates, and a high rate of return to sports.
Arthroscopic ankle lateral ligament instabilities repair
Authors: Pitarini Astuti
Published: October 2024

Lateral ankle sprain is one of the most common sports injuries both in high level and recreational athletes. The frequency of injuries increases in recent years as more sports participations grow. Untreated ankle sprain can lead to deteriorated chronic lateral ankle instability (CLAI/LAI), thus understanding the management is of most important.

Surgery for ankle instability can varied from a simple non augmented repair, augmented repair using autograft/allograft/or other choices of internal bracing, and revision cases of failed primary repair. The decision of what surgery is of the surgeon learning curves. However, with a proper diagnosis, a simple non augmented repair is acceptable with high success rate. In certain population and narrow indication, surgeon need other armamentarium such as augmented reconstruction using graft or other technique to avoid failure of primary case that leads to revision.

Anterior arthroscopic for anterior talofibular ligament (ATFL) repair is widely performed for CLAI. Many studies have reported excellent outcomes, however recurrent instabilities still become a common concern for many. Selected individuals with good indication will prevent the surgeon from revision surgeries. Surgeon need to add the risk factors such as poor ATFL remnants, involvement of calcaneofibular ligament (CFL), and preoperative activity level to their decision making.

At last, the success of lateral ankle instability surgery is also dependent on proper phases of rehabilitation period. Understanding all matter that involves in the recovery of lateral ankle ligament repair is of most important for the best outcome of the patients.
ACL Reconstruction In Laxity Patient
Authors: Utoyo Ghuna Arioharjo
Published: October 2024

Introduction:

The anterior cruciate ligament (ACL) is the most commonly injured in the knee and among the most commonly treated sporting injuries. This number has been increasing annually over the last decades. With the increasing incidence of this injury, there also is an inevitable increase in the number of failures and revision surgeries. ACL failure is most commonly caused by a technical error (non anatomic tunnel placement, impingement), biologic failure (graft choice), laxity, infection, and post-traumatic wear/failure. Patients who had generalized joint laxity would have worse outcomes and graft selection was a challenge for this condition

Disscusion:

Restoring knee joint laxity, to improve knee function, is the primary goal of ACL reconstruction. Nowadays, autografts that usually used for ACLR are BPTB and HT, but each technique has advantages and disadvantages, make a controversy regarding potential of grafts to restore knee laxity. In patients who have excessive joint laxity, the five-year outcomes of ACL reconstruction with bone-patellar tendon-bone grafts are better than those with hamstring grafts in terms of functional outcomes. Double Bundle was better functional outcomes than Single Bundle. HT used more frequently for primary ACLR. BPTB associated with donor-site morbidity problems compared with HT.

Conclusion:

Generalized joint laxity could be considered one of the risk factors for poor outcomes after ACL reconstruction. Any solution would give a good contribution for dealing with ACL with laxity, even though the simplest one. A careful preoperative evaluation, proper surgical technique and well monitored post operative rehabilitation, affect the final outcome after a ligament reconstruction.
Open Reduction Internal Fixation to Fix Posterior Cruciate Ligament Tibial Avulsion
Authors: Wien Aryana IGN
Published: October 2024

Tibial avulsion fractures of the Posterior cruciate ligament (PCL) are common; however, methods of surgical treatment are insufficiently described. PCL is the main posterior stabilizer of the knee and limits posterior tibial translation relative to the femur . In addition, the PCL serves as a central axis controlling and imparting rotational stability to the knee. Isolated tear or avulsion of the PCL can be caused by falling onto a flexed knee or by striking the flexed tibia on the dashboard during a motor vehicle accident . Isolated PCL disruption most commonly occurs as avulsion at the point of tibial insertion, as opposed to its femoral origin or as a mid-substance tear. The tibial insertion of the PCL is also more consistent than the femoral insertion. The two PCL fibre bundles insert, without anatomic separation, into the centrally-located fovea or facet on the posterior aspect of the tibia, 1-1.5 cm distal to the joint line, with the posterior horn of the medial meniscus being the anterior-most extension . Chronic disability and early degenerative changes can develop as a result of delayed diagnosis.

The posteromedial knee approach is a surgical technique for treating tibial avulsion fractures of the PCL. The technique involves reinsertion and fixation of the PCL bone fragment into its anatomical bed located on the posterior tibial surface. The posteromedial knee approach is reportedly sufficient for re-establishing ligament integrity and function; however, most surgeons are not familiar with this surgical approach because it is poorly-described within the published literature.
Meniscal ramp lesion: Is a routine repair necessary?
Authors: Giarso Peter
Published: October 2024

Meniscal ramp lesions are injuries of longitudinal vertical and/or oblique peripheral tears of the posterior horn of the medial meniscus at the meniscocapsular junction or the meniscotibial ligament and are frequently associated with concomitant anterior cruciate ligament (ACL) injury.

Arthroscopy remains the diagnostic gold standard as magnetic resonance imaging has limited sensitivity. Biomechanically, ramp lesions are known to increase anterior tibial translation and rotational laxity. Clinical investigations regarding optimal management are largely limited to studies of low evidence levels.

There is some evidence to suggest that ramp lesion repair at the time of ACL reconstruction restores joint kinematics and that ramp lesion repair is safe and efficacious. Patients with unstable lesions may also benefit from surgical repair compared to a more minimalist approach, primarily in situations where the lesions is found to be unstable during arthroscopic manipulation.

While case series have demonstrated that repair is safe and efficacious, comparative studies have failed to suggest that repair of stable lesions results in superior outcomes when compared to conservative treatment approaches. However, repair may be warranted in unstable ramp lesion injuries despite the increased risk for revision surgery. The current body of clinical literature is limited, and further robust, long-term study is warranted to better guide injury diagnosis and management protocol.
High Tibial Osteotomy in Sport-Related Cases
Authors: Valentino Rawung Rangga
Published: October 2024

High Tibial Osteotomy (HTO) is a surgical procedure increasingly employed in sport-related cases with the aim of preserving knee joint function and delaying or altogether avoiding knee compromise. This technique involves the realignment of the tibial plateau through controlled bone cuts, resulting in an optimized distribution of forces on the knee joint.

Sport-related activities often lead to unique knee joint stresses, particularly in cases of chronic anterior cruciate ligament (ACL) deficiency, varus malalignment, or early-stage osteoarthritis. HTO offers an alternative treatment option for athletes and active individuals seeking to maintain their performance levels while simultaneously addressing their knee joint issues. This procedure offers an effective approach to alleviate symptoms, correct alignment, improving stability, preserve meniscal tissue and cartilage,

The HTO procedure can be a procedure offered along with ligament reconstruction procedures and other soft tissue repairs in the knee in mal-aligned knee conditions. Studies show that there is a relationship between failure of ACL reconstruction and others soft tissue procedurs and mal alignment of the knee

Although HTO offers many advantages, careful patient selection and evaluation is essential to maximize the likelihood of a successful outcome. A comprehensive preoperative assessment, including physical examination, radiographic evaluation, and review of detailed medical history, type of exercise, and patient expectations will help identify eligible patients and reduce the potential for complications.
The Importance of Preoperative Rehabilitation in Knee Ligament Reconstruction Surgery
Authors: Alit Pawana I Putu
Published: October 2024

The ACL is a central ligament of the knee. The main functional role of the ACL is to provide stability against anterior tibial translation (ATT) and internal rotation.

Pre rehabilitation improved patient reported symptoms (Modified Cincinnati Knee Rating System) at 12-weeks post operation. Increased subjective knee scores are associated with increased psychological readiness for return to activity, at 12-weeks post-operation; single leg hop distance/LSI scores were significantly higher in the group who received pre rehabilitation compared to the control group.

Goals and benefits of ACL prehabilitation are restore knee range of motion, lower extremity strength, especially quadriceps, knee stability, balance, proprioception, confidence in return to sport and reduce likelihood of reinjured or contra lateral injury. ACL contains mechanoreceptors which affect neuromuscular control of the knee beyond its mechanical function of maintaining knee joint stability

The surface EMG can be useful for evaluation of muscle strength and balance for pre operative rehabilitation preparation and also during rehabilitation after ACL injury.
Neuromuscular Training in ACL Injury Prevention: A Narrative Review
Authors: Pangestuputra Agil Wahyu , Changestu Daniel Alexander
Published: October 2024

Introduction and objective:

Anterior cruciate ligament (ACL) injuries remain a significant concern in sports, demanding effective prevention strategies. Neuromuscular training offers promise by enhancing neuromuscular control and biomechanics, potentially reducing ACL injury risks. This narrative review systematically assesses the current literature regarding the effectiveness of neuromuscular training in ACL injury prevention. Encompassing diverse exercises—balance, strength, plyometrics, agility, core stability—and biomechanical analyses, the review highlights multifaceted benefits. Improvements in muscular strength, joint stability, movement mechanics, and neuromuscular coordination are prominent. Moreover, the review emphasizes tailored and progressive protocols, while also addressing potential implementation challenges. Through this synthesis, the narrative review helps us comprehend the crucial part that neuromuscular training plays in preventing ACL injuries, which calls for more research and its incorporation into athletic and rehabilitation programs. The goal is to advance knowledge of the function of neuromuscular training in preventing ACL injuries, in post-ACL Reconstruction therapy, and to offer insightful information to both researchers and practitioners in the field.

Methods:

This narrative review utilized PubMed to search for studies using Medical Subject Headings (MeSH) terms related to Anterior Cruciate Ligament Injuries, Neuromuscular Training, Motor Learning, Biomechanics Exercise therapy/methods, Knee Injuries/prevention & control, Sports Medicine and Rehabilitation. Searches were confined to titles and abstracts of English-language studies. Inclusion criteria encompassed studies focusing on football athletes (excluding para athletes), across genders, featuring NMT, and targeting primary or secondary injury prevention, including post-ACL Reconstruction Rehabilitation.

Result:

From an initial pool of 556 studies, 15 were selected for full-text review after title and abstract screening. Following rigorous comparison against eligibility criteria, 6 studies were included in this narrative assessment.

Conclusion:

This narrative review offers insights from recent research endeavors aimed at optimizing ACL injury prevention and refining post-ACLR rehabilitation strategies. Key findings emphasize the integration of motor learning concepts, utilization of external focus cues within neuromuscular training, and tailored programs designed for specific sports. Studies consistently highlight the potential for improved motor skill acquisition, reduced injury susceptibility, and enhanced biomechanical attributes. Cumulatively, these insights offer valuable guidance for the fine-tuning of ACL injury prevention and rehabilitation protocols.
Surgical Repair of Stener-like Lesion of the Medial Collateral Ligament of the Knee
Authors: Riantho Albert , Parsaoran Butarbutar John Christian , Fidiasrianto Kevin , Ivander Gian
Published: October 2024

Introduction:

Superficial medial collateral ligament (sMCL) tears of the knee will usually be treated non-surgically. But in some cases such as those with tears at the distal insertion, where it may displace over the pes anserinus tendons (Stener-like lesion), surgery will be performed. Here, we describe a patient with acute traumatic Stener-like lesions of sMCL based on clinical evaluation and imaging results, who underwent primary surgical repair.

Case Presentation:

A 26 years old male patient was admitted to the outpatient clinic with a chief complaint of left knee pain after valgus trauma on the left knee while playing badminton 5 days prior. Clinical examination revealed a moderate swelling and there was tenderness on the medial joint line. The full knee flexion was restricted due to swelling. A valgus stress test showed laxity of the medial joint. The anterior drawer and Lachman test showed anterior laxity. A left knee joint aspiration was done and 45 cc of red cloudy synovial fluid was aspirated. On the MRI examination, a bunched MCL with a displacement of the tibial insertion site over the per anserinus tendons was identified, along with the complete rupture of the ACL. The patient underwent two-stage treatment : an arthroscopic ACL reconstruction and surgical repair of the MCL. After the surgery, the patient wore a knee brace fixed in full extension for 4 weeks. The patient also followed a standard ACL rehabilitation protocol. Follow up were done 6 months after the surgery.

Results:

At final follow-up, the patient had regained normal stability of the MCL without any laxity in comparison to the contralateral knee. The anterior drawer and Lachman test had returned to normal. Patient was completely pain-free and did not have any complaints of instability.

Discussion:

Surgical repair is indicated in specific circumstances such as a Stener-like lesion in which the interposition of the pes anserinus between the ligament impeding the healing process of MCL. Prompt surgical intervention can restore the anatomic position of the MCL, promote anatomic healing, and prevent long-term valgus instability.

Conclusion:

Stener-like lesion of the MCL are rare, and early diagnosis is important in treating this condition. Surgical treatment must be done to provide complete healing of the MCL.
Lateral Discoid Meniscus: A Case Report
Authors: Anggrian  , Utoyo Ghuna Arioharjo
Published: October 2024

Introduction:

Discoid lateral meniscus is a deformity of the meniscus characterized by hypertrophy of the central portion of the meniscus; the incidence rate ranges from 3% to 5% and reaches 15% in Asian ethnicities. Previous researchers have hypothesized that failure to internalize the central portion of the meniscus during embryonic and fetal development due to genetic mutations may be the cause of this disorder. In a number of studies, the detection and selection of appropriate measures have yielded positive results.

Case:

We reported a 33-year-old male patient complaining that the left leg feels like locking since 4 months ago, previously the patient complained of a left knee sounding "click" after falling while running fast. Patient was diagnosed with a lateral discoid meniscus of the left knee after undergoing a physical examination, an x-ray examination, and an MRI examination. For a torn lateral discoid meniscus, the patient underwent knee arthroscopy and saucerization.

Discussion:

Discoid meniscus is an anatomical variation of discus-related injuries. The diagnosis is based on the "bow-tie sign" and can be diagnosed by the MRI. The total arthroscopic approach is used to determine the normal position of the discoid, while the saucerization technique is used to maintain normal position. Studies have shown that the saucerization technique can improve the stability of the discoid, reduce neurovascular damage, and reduce the potential of the chondral structure. The combination of saucerization and arthroscopic techniques can help minimize the risk of discoid meniscus injuries.

Conclusion:

Cases of discoid meniscus are uncommon, and their etiology remains unknown. In asymptomatic cases, conservative is the treatment of choice, whereas in cases with symptoms, surgery can be performed. Saucerization with arthroscopy is currently the most commonly used procedure in its management.
Simultaneous Bilateral Quadriceps Tendon Rupture in A Diabetic Patient: A Rare Case Report and Surgical Technique
Authors: Utoyo Ghuna Arioharjo , Setiadi Christian
Published: October 2024

Introduction & Objectives:

In orthopaedic medicine, a quadriceps tendon rupture (QTR) is an uncommon finding that needs appropriate surgical care to prevent permanent deformity and loss of knee function. Diabetic patients may experience spontaneous quadriceps tendon rupture due to compromised microvascular supply, which puts the quadriceps tendon at risk for fiber degradation and a reduced resistance. Early surgical management is needed to reinsert the tendon at the superior aspect of the patella. Here, we aimed to describe a rare case and the surgical technique of bilateral simultaneous quadriceps tendon rupture in a diabetic patient.

Case Presentation:

A 78-year-old man with a history of diabetes presented at the hospital due to his inability to straighten his left leg, accompanied by pain. His left knee showed swelling, limited range of motion, and a visible gap in the quadriceps tendon above the patella. The patient had intact pulses in the leg. Radiographic images displayed displacement of the patella, and MRI revealed a disrupted tendon with bleeding and swelling. A preliminary diagnosis of quadriceps tendon rupture was made. The patient underwent surgery to repair the tendon, in this patient we use midline incision, refreshed the ruptured ends. We use tape sutured with Bunnel technique and two suture anchor were running locked krackow stitiches to get more rigid fixation. After operation patient received post-operative rehabilitation with brace is fixed in full extension for 1 weeks and exercise isometrically. Patient can mobilization but uses 2 crutches. After 1 week of immobilization, the range of motion is increased gradually by 10° of flexion per 1-week periods. His final knee range of motion was 0° to 125° in both legs after an entire course of physiotherapy. He was discharged from the clinic after six months and returned to work.

Conclusions:

Quadriceps tendon rupture is a rare injury that is typically accompanied by a chronic medical condition. Therefore, as the rupture may be the first indication of an underlying problem, patients with bilateral QTR should be assessed for underlying pathologies such as diabetes mellitus or other endocrine disorders, renal, autoimmune, or rheumatologic diseases and we must use rigid fixation because in this chronic medical condition, patient has the risk of reruptured.
Arthroscopic Approach for Fixation of a Neglected ACL Avulsion Fracture: A Case Report
Authors: Febrianto Dani Pratama , Winata Fahroni C.
Published: October 2024

Introduction:

Anterior cruciate ligament (ACL) avulsion fractures constitute a significant proportion of knee joint injuries and can lead to substantial disability if left untreated. These fractures result from forceful hyperextension or a direct impact on the distal end of the femur while the knee is flexed. Presently, Meyers and McKeever's classification system is used to categorise these fractures. The popularity of arthroscopic reduction and fixation techniques due to limited skin incisions and soft-tissue injuries have been growing since there is no gold standard treatment for ACL avulsion fractures. This report aims to describe the potency of arthroscopic techniques in fixing neglected ACL avulsion fractures to improve knee function and calculate it using Patient-Reported Outcome Measures (PROM), the Indonesian version of International Knee Documentation Committee (I-IKDC).

Objective:

A 19-year-old young woman sustained an ACL injury during a sports activity. Over time, her pain progressively worsened and limiting her ability to perform fully extend her knee and a full squat. X-ray and MRI revealed evidence of avulsion at the ACL insertion site on the tibia, classified as a grade 2 based on Meyers and McKeever's Classification. Despite undergoing conservative therapy, the pain persisted for 8 weeks before the patient was admitted for surgery.

Discussion:

Her pain really limits her daily activities and her career as a sales promotion representative. For the surgical technique, we did a meticulous cleaning of the fracture site, followed by fixation utilizing a fiber suture. Next, a looping suture was created at the ACL insertion point, threaded through a tibial hole, and fixed at the anterior tibia, aligning with the location of the ACL insertion. Three months after the surgery, we did a follow-up and found that she has no pain when she fully extends her knee, does a squat, and also does light jogging. Her X-ray postoperative shown a united avulsion fracture. We also calculated using I-IKDC and found a satisfactory result of 83% for her knee function.

Conclusion:

The arthroscopic approach achieved a satisfactory clinical outcome and provided an effective method for the treatment of neglected ACL avulsion fractures..
Arthroscopic Assisted Management Malunion of Tibial Plateu Fracture: A Case Report
Authors: Febrianto Dani Pratama , Winata Fahroni C.
Published: October 2024

Introduction:

A tibial plateau fracture constitutes 1% of all fractures and usually occurs as a result of falls or motor vehicle accidents. Men are more susceptible to experiencing this injury through high-energy mechanisms and often accompanied by soft tissue injuries. Failure in the initial treatment can lead to malunion of the tibial plateau fracture, which frequently results in impaired knee functionality. Severe malunion is necessary for surgery to restore basic knee function. This report aims to outline the benefits of using arthroscopy-assisted open reduction and internal fixation (ORIF) surgery for malunion tibial plateau fractures.

Objective:

A 20-year-old male experienced a motorcycle accident. He feels pain when he flexes and extends his knee. Radiological assessments, including X-rays and CT scans, revealed a malunion of depressed medial component of the tibial plateau, classified as a tibial plateau fracture type 4 based on Schatzker’s classification. The symptoms persisted for 34 weeks before surgical intervention.

Discussion:

Arthroscopic-assisted ORIF surgery was performed to realign the irregular bone fragments and stabilize the bone using implants and screws. The arthroscopy was used during surgery to locate the intraarticular malunion site. Two guide wires were inserted with the help of an ACL guide, and then we performed the osteotomy procedure along the guide wires. Next, the fracture site was openly reduced and internally fixed (ORIF) confirmed by using arthroscopy. Simultaneously utilizing arthroscopy and ORIF were chosen for their combined ability to precisely identify fracture borders, using guide wires to accurately pinpoint the osteotomy site. Two months after the surgery, we did a follow-up and found that he has no pain when he flexes and fully extends his knee. The follow-up X-ray also shown good alignment of the tibial plateau.

Conclusion:

The arthroscopic-assisted ORIF approach yields favorable clinical outcomes, reduces scar tissue-induced pain, improves post-operative knee function, and is effective in treating malunion tibial plateau fractures..
Ankle Subluxation and Associated Ruptures: A Case Report on Surgical Intervention in a 47- year-old Male Badminton Military Athlete
Authors: Rezha Danny M , Indrayana Sagitha
Published: October 2024

Introduction & Objectives:

This study presents the clinical approach and surgical management of a 47-year-old male patient without prior medical history or comorbidities, who experienced acute ankle pain following a distinctive "klek" sound during badminton activity. The objective is to demonstrate the significance of accurate diagnosis and appropriate surgical intervention for such injuries.

Materials & Methods:

A comprehensive patient history was taken, coupled with a physical examination and diagnostic imaging, which identified the primary complaint of ankle pain. The subsequent diagnosis was an ankle subluxation, intraosseous rupture of the tibia fibula, and rupture of the Achilles tendon. Intervention consisted of an open reduction of the ankle and Achilles tendon repair, performed under regional anesthesia.

Results:

The surgical procedure was executed successfully with no immediate post-operative complications. The patient's post-surgical recovery was thoroughly monitored, and rehabilitation began promptly to regain full function and mobility.

Conclusion:

This case underscores the importance of a precise diagnosis in orthopedic injuries and the need for tailored surgical procedures to effectively address them. Open reduction and Achilles repair were pivotal in treating the ankle subluxation and related ruptures. Such cases augment the understanding of orthopedic surgical techniques for specialized injuries, emphasizing patient-specific diagnosis and management.