bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reconstruction of the lateral ankle ligaments
Authors: Colville Mark R. , Marder Richard A. , Zarins Bertram 
Published: June 2007

The purpose of this study was to perform a biome chanical analysis of several commonly performed op erative procedures used to stabilize the lateral ankle. We performed the Evans, Watson-Jones, and Chris man-Snook procedures on 15 cadaveric ankles and tested the ankles for stability, motion, and isometry of graft placement. The Evans procedure allowed in creased anterior displacement, internal rotation, and tilt of the talus when compared to ankles with intact liga ments. Subtalar joint motion was restricted by the Evans procedure. The Watson-Jones procedure con trolled internal rotation and anterior displacement of the talus, but was less effective in controlling talar tilt and also restricted subtalar joint motion. The Chrisman- Snook procedure allowed increased internal rotation and anterior displacement of the talus when compared to ankles with intact ligaments. The procedure was effective in limiting talar tilt, but restricted subtalar joint motion. Based on the biomechanical data obtained, we de vised a lateral ankle reconstruction with bone tunnels that reproduce the anatomic orientation of both the anterior talofibular and calcaneofibular ligaments. This ankle ligament reconstruction resists anterior displace ment, internal rotation, and talar tilt without restricting subtalar joint motion. Clinical relevance: We found considerable mechanical differences among the more commonly performed lat eral ankle reconstructions. It is possible to locate bone tunnels and graft placement so that a more anatomic configuration is achieved.
Meniscal transplantation using fresh and cryopreserved allografts
Authors: Jackson Douglas W. , McDevitt Cahir A. , Simon Timothy M. , Arnoczky Steven P. , Atwell E. Allan , Silvino Nicholas J. 
Published: June 2007

A comparative study of three subgroups of meniscal transplants was undertaken in the goat model: Group 1 (autograft) involved removal and immediate reimplan tation of the meniscus; Group 2, fresh meniscal allo grafts ; and Group 3, cryopreserved (30 days) meniscal allografts. Six months after surgery, tissues were eval uated for gross degenerative changes, proteoglycan concentration (as assessed by uronic acid), water con tent, vascularity, histology, and cell viability. The con tralateral knee served as control for all comparisons. There was no statistical difference in the amount of arthritis present and all transplants demonstrated an essentially normal peripheral vascularity compared to controls. Sections revealed reduced numbers of cells in the central portions of the transplanted menisci and these viable cells demonstrated different behavior in multiplication in tissue culture compared to contralateral controls. Grossly and microscopically, the implanted menisci differed little from the controls. The measurement of proteoglycan concentration and water content of the transplanted meniscal cartilage suggest alterations that may affect the long-term mechanical properties. The autograft specimens showed the water content was very slightly increased (3% to 6%), while the proteogly can concentration was increased (42% in terms of uronic acid). In contrast, the water content of the fresh allograft group and the cryopreserved group was in creased 12% to 24%. Proteoglycan concentration in these groups was decreased up to 56% in portions of some menisci compared to controls. Fresh and cryopreserved meniscal allografts showed peripheral healing, revascularization, cellularity, and in corporation, and grossly appeared good at 6 months in the goat model. The biochemical changes in the extra cellular matrix at 6 months raises questions on the long- term function of these transplanted menisci.
The anterior cruciate ligament-deficient knee with varus alignment
Authors: Noyes Frank R. , Schipplein Owen D. , Andriacchi Thomas P. , Saddemi Stephen R. , Weise Marc 
Published: June 2007

Thirty-two patients with an ACL-deficient knee and lower limb varus alignment and 16 healthy controls were analyzed during level walking using a force-plate and optoelectronic system. The forces and moments of the lower limb and knee joint were measured and knee joint loads and ligament tensile forces were cal culated using a mathematical model. The majority of patients (20 of 32) had an abnormally high adduction moment at the affected knee. The ad duction moment showed a statistically significant cor relation to high medial tibiofemoral compartment loads and high lateral soft tissue forces, but not to the degree of varus alignment on standing roentgenograms. Fif teen of 32 knees had abnormally high lateral soft tissue forces. We interpreted these gait findings as indicative of a medial shift in the center of maximal joint pressure and an increase in lateral soft tissue forces to achieve coronal plane stability. Further, there is the likelihood of separation of the lateral tibiofemoral joint and "con dylar lift-off" during periods of the stance phase. If this occurs, all of the load-bearing forces would shift to the medial tibiofemoral joint and relatively large tensile forces would occur in the lateral soft tissue restraints. The flexion moment, as related to the quadriceps muscle force, was significantly lower than the control knees in 40% of the involved knees, and the extension moment, as related to the hamstring muscle force, was significantly higher in 50% of the involved knees. We interpret this finding as a gait adaptation tending to diminish quadriceps muscle activity and enhance ham string muscle activity to provide dynamic anteroposte rior stability of the knee joint. The fundamental assumption of this paper is that any combination of conditions leading to higher medial joint forces is associated with factors leading to more rapid degeneration of the medial compartment in patients with ACL deficiency, varus deformity, and lax lateral ligaments.
Characteristics of the isokinetic performance of patients with injured cruciate ligaments
Authors: Shirakura Kenji , Kato Kazuo , Udagawa Echi 
Published: June 2007

The torques of the quadriceps muscle in patients with cruciate ligament injuries were evaluated under isoki netic contraction. There were 30 patients with anterior cruciate ligament injuries, 19 with posterior cruciate ligament injuries, and 30 controls. The torques of concentric and eccentric contractions in anterior cruciate ligament-injured knees showed a significant difference from those in the uninjured sides at extension angles of less than 45°, yet the values of the peak torques for concentric and eccentric contrac tions were the same as those for the uninjured sides. The torques of concentric and eccentric contractions in posterior cruciate ligament-injured knees showed a sig nificant difference from the uninjured sides at flexion angles of more than 36°. The peak torques for concen tric and eccentric contraction also showed a significant difference from the uninjured sides. The concentric and eccentric peak torque angles of the injured knees were similar to those of the uninjured sides in all subjects. The ratios of eccentric to concentric peak torque of the contralateral knees in the anterior cruciate ligament- injured groups did not show a significant difference from those of the controls. The evaluation of the bio mechanical change in these categories is of great ad vantage in determining proper methods of treatment and rehabilitation.
High tibial osteotomy and ligament reconstruction in varus angulated, anterior cruciate ligament-deficient knees
Authors: Noyes Frank R. , Barber Sue D. , Simon Richard 
Published: June 2007

We assessed short-term treatment results of younger patients with varus malalignment and chronic anterior cruciate ligament deficiency. Forty-one patients (mean, 32 years; range, 16 to 47) underwent a high tibial osteotomy. Because of giving way symptoms, 14 also had a lateral iliotibial band extraarticular procedure at the time of the osteotomy and 16 had an intraarticular anterior cruciate ligament allograft reconstruction after the osteotomy. All returned for followup (mean, 58 months; range, 23 to 86), which included KT-1000 arthrometer testing and evaluation by our knee rating system. Statistically significant ( P < 0.05) improvements were found in the mean overall rating scores for pain, swell ing, and giving way. Preoperatively, 30 (73%) had pain with activities of daily living or with any sports activity; 11 (27%) could perform only light sports activities with out pain. At followup, 32 patients (78%) had no pain with activities of daily living or light sports. Ten of 15 patients with advanced medial tibiofemoral arthrosis (subchondral bone exposure) had significant improvements in symptoms. Patient satisfaction was high: 88% stated they would undergo the procedure again and 78% felt their knee condition was improved. Patients who had the allograft reconstruction had significantly lower ( P < 0.05) anterior-posterior dis placements at followup than those who had the extraar ticular procedure. We concluded that osteotomy should be performed early in the disease process for younger athletes who experience symptoms with activity. It may be unrealis tic, however, to expect continuation of sports beyond light recreational, given the joint arthrosis that is usually present and the high in vivo joint loadings with athletes. Anterior cruciate ligament reconstruction should be considered when giving way previously occurred and the patient plans to resume athletics. However, patients with advanced arthrosis can avoid anterior cruciate ligament surgery by reducing athletic activities.
Acute repair of injury to the anterior cruciate ligament
Authors: Cross Mervyn J. , Wootton J.R. , Bokor Desmond J. , Sorrenti Sam J. 
Published: June 2007

We reviewed 30 patients at an average of 7.4 years after acute repair of the anterior cruciate ligament aug mented with a loop of iliotibial tract. A noncontact twisting had been the mechanism of injury in 18 of these patients, with 28 having been injured in sports. At followup, 25 patients had not experienced symptoms of instability and 23 were able to return to unrestricted athletic activity; only 5 had been unable or unwilling to return to sporting activity at all. There had been no swelling in 23 patients; however, 17 suffered from pain on exertion. The average Lysholm score was 93.2. Joint laxity was assessed and anteroposterior tibial translation quantified with a KT-1000 arthrometer. Eighteen patients had a normal or 1+ Lachman test and 27 had an absent or 1 + pivot shift. When compared with the results of a similar study performed on this group of patients at 2 years after surgery, there had been little subjective change in knee function. However, objectively there had been significant deterioration of the anteroposterior stability of the knees at 7 years, suggesting failure of the integrity of the repaired liga ment with time. An associated medial collateral ligament injury had a significant adverse effect both on the integrity of the anterior cruciate ligament repair and the incidence of postoperative stiffness.
A review of allograft processing and sterilization techniques and their role in transmission of the human immunodeficiency virus
Authors: Asselmeier Marc A. , Caspari Richard B. , Bottenfield Scott 
Published: June 2007

Human immunodeficiency virus (HIV) infection via vas cular organ and tissue transplantation is well docu mented. The majority of these transmissions occurred before the development of HIV antibody testing, which is now a routine screening tool used before organ and tissue procurement and transplantation. There exists what is commonly referred to as a "window" of sero negativity after HIV infection. Potential donors may be infectious with the HIV virus but not yet detected with available HIV antibody tests. Bone and soft tissue retrieval may be done in either a sterile or clean, non- sterile manner. Deep freezing and freeze-drying (lyoph ilization) are two commonly used modes of preserving bone and soft tissue allografts. In 1985, a screened donor who was in the window of seronegativity underwent vascular organ and mus culoskeletal tissue harvest. The bone and soft tissue procured underwent a variety of processing and pres ervation techniques. There have been no known cases of HIV transmission from the processed freeze-dried tissues. Evidence now exists that early HIV infection, before HIV antibody production, may be the most infectious period. The HIV antigen testing may allow earlier detec tion of an infectious donor, thus closing the window of seronegativity. It is unknown whether this nontransmis sion of HIV to the recipients of the processed and freeze-dried tissue was due to the processing or the nature of the tissue itself.
Sports and osteoarthrosis of the hip
Authors: Vingård Eva , Alfredsson Lars , Goldie Ian , Hogstedt Christer 
Published: June 2007

To investigate if participation in sports increases the risk of developing osteoarthrosis of the hip, we did a case-control study on the sports activities of 233 men (up to age 49) who were recent recipients of a prosthe sis because of severe idiopathic osteoarthrosis of the hip and 302 men randomly selected from the general population. Assessments of sports, job history, and health status were made by an interview. Men with high exposure to sports of all kinds com bined (in hours) had a relative risk to develop osteoar throsis of the hip of 4.5 compared to those with low exposure. Track and field sports and racket sports seemed to be the most hazardous to the hip joint. Men who had been exposed to high physical loads both from their occupation and sports had a relative risk of 8.5 to develop osteoarthrosis of the hip compared to those with low physical load in both activities. Potential confounding factors, such as age, body mass index, and smoking, were considered. Long-term exposure to sports among men seems to be a risk factor for developing severe osteoarthrosis of the hip; this is increased when combined with heavy load from occupation.
Effects of postoperative immobilization on the reconstructed anterior cruciate ligament
Authors: Muneta Takeshi , Yamamoto Haruyasu , Takakuda Kazuo , Sakai Hiroshi , Furuya Kohtaro 
Published: June 2007

To investigate the effects of postoperative immobiliza tion and limited motion on reconstructed anterior cru ciate ligaments, 28 rabbits received an anterior cruciate ligament reconstruction using autogenous Achilles ten don and were then divided into three groups: fully immobilized, 4 weeks immobilized, and limited motion. Two rabbits from each group were evaluated macro scopically, histologically, and microangiographically at 4-week intervals until 12 weeks postoperatively. An additional six rabbits in the 4 weeks immobilized and limited motion groups were studied biomechanically at 12 weeks postoperatively. Macroscopically, both immobilized groups showed more proliferation of the infrapatellar fat pad, which was adherent to the reconstructed anterior cruciate liga ment. Histology revealed more rapid regeneration of reconstructed anterior cruciate ligaments in the limited motion group, with no findings of necrosis in the mid- substance. Microangiography indicated faster normali zation of vascularity in the limited motion group. The biomechanical study showed no significant difference in laxity between the 4 weeks immobilized and limited motion groups. The graft stiffness and maximum load to failure were greater for the limited motion group, although the increase was not statistically significant. The histologic and microangiographic results from the limited number of animals in this study support limited postoperative motion in the anterior cruciate ligament reconstructed knee. However, there were no differ ences in terms of the biomechanical parameters at 12 weeks postoperatively between the immobilized and limited motion treatment modes.
Dacron ligament reconstruction for chronic anterior cruciate ligament insufficiency
Authors: Wilk Richard M. , Richmond John C. 
Published: June 2007

We report the 5-year follow-up results of a prospective, multicenter study evaluating the use of a Dacron pros thetic ligament in reconstruction of anterior cruciate- deficient knees. The study group consisted of 84 pa tients, followed for at least 5 years. The patients were divided into 2 groups: 50 patients with isolated anterior cruciate ligament laxity (Group 1) and 34 patients with a failed previous anterior cruciate ligament surgery or combined laxities (Group 2). Two surgical techniques were employed: reconstruction through drill holes in the tibia and femur (30 patients) and reconstruction using the over-the-top position with the Dacron ligament wrapped in a strip of iliotibial band (54 patients). The overall failure rate was 35.7% at 5 years. The failure rate at 2 years was 20%, illustrating a significant deterioration of results between the two follow-up in tervals. Evaluation of subjective criteria using the Lysh olm score showed an improvement from preoperative status at the 2-year followup; however, there was a slight decline when 5-year results were evaluated. Teg ner activity levels increased from a mean of 2.9 ± 2.1 at the preoperative visit, to a mean of 4.9 ± 2.0 at the 2-year followup and a mean of 5.0 ± 2.0 at the 5-year visit. These results show that the Dacron ligament pros thesis achieves the short-term goal of restoring stability and improving function and may be sufficient to provide long-term stability for the anterior cruciate-deficient knee.
Posterior subluxations of the medial and lateral tibiofemoral compartments
Authors: Noyes Frank R. , Stowers Stewart F. , Grood Edward S. , Cummings John , VanGinkel Laura A. 
Published: June 2007

We report for the first time the abnormal increases in posterior subluxation of the medial and lateral tibial plateaus after sectioning the posterolateral structures and posterior cruciate ligament. We applied specific forces and moments to the knees of seven cadaveric whole lower limbs and measured the position of the tibia at which the ligaments and the geometry of the joint limited motion. Removal of only the posterolateral structures resulted in an average increase in posterior translation of the lateral tibial plateau of 8.0 mm (range, 5.7 to 10.6) at 30° of flexion over the intact state (P < 0.01), but no significant increase at 90° of flexion (mean, 2.7 mm). Knees with underlying physiologic cruciate ligament laxity (high anterior/posterior displacement in the intact knee) had the greatest lateral tibial plateau subluxation (P < 0.01). There was no abnormal posterior translation of the medial tibial plateau. After sectioning the poste rior cruciate ligament and the posterolateral structures, statistically significant increases in posterior translation of both the medial and lateral tibial plateaus occurred at 30° and 90° of flexion (P < 0.01). The increase in posterior translation of the lateral tibial plateau over the intact state averaged 17.8 and 23.5 mm at 30° and 90° of flexion, respectively; for the medial tibial plateau this increase averaged 7.6 and 12.3 mm at 30° and 90° of flexion, respectively. The diagnosis of abnormal tibiofemoral rotatory sub luxations requires knowledge of the anteroposterior direction and magnitude of each tibial plateau under both low flexion and high flexion knee angle positions.
Patellar tendon length change after anterior cruciate ligament reconstruction using the midthird patellar tendon
Authors: Shaffer Benjamin S. , Tibone James E. 
Published: June 2007

The purpose of this study was to determine if use of the midthird patellar tendon autograft contributes to or causes patellar tendon shortening or patella baja in anterior cruciate ligament reconstruction. Thirty-six pa tients undergoing arthroscopically assisted midthird pa tellar tendon autograft anterior cruciate ligament recon struction were studied prospectively. Intraoperative pa tellar tendon length changes were measured. Half of the patients had the tendon defect closed and half had it left open (closing peritenon only). Radiographic ten don length changes and patella baja were assessed using Insall-Salvati and Blackburne-Peel ratios meas ured on 45° lateral knee radiographs using an adjust able polypropylene jig. Bilateral films were obtained preoperatively and at 2 weeks, 3 months, and 6 months postoperatively. No patients demonstrated evidence of patellar tendon shortening greater than the 5.5% measurement error. Tendon defect closure resulted in negligible tendon shortening intraoperatively, averaging 2.28% (1.11 mm). Of the 18 patients whose defects were closed, 5 showed no shortening. The remaining 13 patients had measurable tendon shortening less than 4% (2 mm). No patients developed patella baja.
Partial meniscectomy and anterior cruciate ligament rupture in soccer players
Authors: Neyret Philippe , Donell Simon T. , Dejour David , Dejour Henri 
Published: June 2007

A retrospective review of 77 soccer players with 91 affected knees that had undergone the same operation, a rim-preserving meniscectomy, was made with a min imum followup of 20 years and an average followup of 27 years. The patients were divided into groups based on the presence of an intact (Group 1) or ruptured (Group 2) anterior cruciate ligament. At 5 years after meniscectomy, 75% of Group 1 and 52% of Group 2 were still playing soccer, and 13% in Group 1 as opposed to 28% in Group 2 had given up sports. The sporting class assessment was good in 80% of the Group 1 knees and 62% in the Group 2 knees. By followup, 5% of Group 1 and 32% of Group 2 required further meniscectomies, and 2% of Group 1 and 16% of Group 2 required operations for osteo arthritis. Radiologically diagnosed osteoarthritis was present in 24% of Group 1 knees compared with 77% of Group 2. Functionally, 60% of the Group 1 knees were excellent at followup as opposed to 9% in Group 2 knees. In Group 1, 49% were still involved in sports compared with 22% in Group 2. However, 97% of Group 1 were satisfied with their knees compared with 74% of Group 2. All of these differences were statisti cally significant.
Isolated posterior cruciate ligament reconstruction
Authors: Lipscomb A. Brant , Anderson Allen F. , Norwig Emily D. , Hovis W. David , Brown David L. 
Published: June 2007

From 1973 to 1987, 28 patients seen at our institution sustained isolated posterior cruciate ligament tears. Of these 28 patients, 25 were reevaluated at an average followup of 7 years and 1 month after secondary recon struction of the posterior cruciate ligament using the semitendinosus and gracilis tendons alone or with an extraarticular procedure. Subjectively, 22 of 25 patients related no restrictions regarding activities of daily living, with 14 of 25 patients being able to return to their previous competitive level in sports. Objective evaluation after reconstruction re vealed no change in the preoperative and postoperative posterior drawer examination in 13 of 25 patients, a finding confirmed by KT-1000 arthrometer measure ments. Radiographic evaluation revealed degenerative changes predominantly involving the medial and patel lofemoral compartments in 15 of 25 patients. Despite optimistic subjective reporting, this long-term retrospective study reveals that this procedure incon sistently limits posterior instability and therefore cannot be recommended.