scholarly journals Three-Dimensional Anatomic Evaluation of the Anterior Cruciate Ligament for Planning Reconstruction

2012 ◽  
Vol 2012 ◽  
pp. 1-5
Author(s):  
Yuichi Hoshino ◽  
Donghwi Kim ◽  
Freddie H. Fu
Keyword(s):  
Image Analysis ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Insertion Site ◽  
Three Dimensional ◽  
Human Anatomy ◽  
Reconstruction Surgery ◽  
Anterior Cruciate ◽  
Acl Anatomy

Anatomic study related to the anterior cruciate ligament (ACL) reconstruction surgery has been developed in accordance with the progress of imaging technology. Advances in imaging techniques, especially the move from two-dimensional (2D) to three-dimensional (3D) image analysis, substantially contribute to anatomic understanding and its application to advanced ACL reconstruction surgery. This paper introduces previous research about image analysis of the ACL anatomy and its application to ACL reconstruction surgery. Crucial bony landmarks for the accurate placement of the ACL graft can be identified by 3D imaging technique. Additionally, 3D-CT analysis of the ACL insertion site anatomy provides better and more consistent evaluation than conventional “clock-face” reference and roentgenologic quadrant method. Since the human anatomy has a complex three-dimensional structure, further anatomic research using three-dimensional imaging analysis and its clinical application by navigation system or other technologies is warranted for the improvement of the ACL reconstruction.

scholarly journals Effects of Distally Fixated Versus Nondistally Fixated Leg Extensor Resistance Training on Knee Pain in the Early Period After Anterior Cruciate Ligament Reconstruction

2002 ◽  
Vol 82 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Matthew C Morrissey ◽  
Wendy I Drechsler ◽  
Dylan Morrissey ◽  
Philippa R Knight ◽  
Paul W Armstrong ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Resistance Training ◽  
Acl Reconstruction ◽  
Knee Pain ◽  
Cruciate Ligament ◽  
Early Period ◽  
Kinetic Chain ◽  
Reconstruction Surgery ◽  
Open Kinetic Chain ◽  
Anterior Cruciate

Abstract Background and Purpose. Nondistally fixated (ie, what is often referred to as “open kinetic chain” [OKC]) knee extensor resistance training appears to have lost favor for some forms of rehabilitation due partly to concerns that this exercise will irritate the extensor mechanism. In this randomized, single-blind clinical trial, nondistally fixated versus distally fixated (ie, often called “closed kinetic chain” [CKC]) leg extensor training were compared for their effects on knee pain. Subjects. Forty-three patients recovering from anterior cruciate ligament (ACL) reconstruction surgery (34 male, 9 female; mean age=29 years, SD=7.9, range=16–54). Methods. Knee pain was measured at 2 and 6 weeks after ACL reconstruction surgery using visual analog scales in a self-assessment questionnaire and during maximal isometric contractions of the knee extensors. Between test sessions, subjects trained 3 times per week using either OKC or CKC resistance of their knee and hip extensors as part of their physical therapy. Results. No differences in knee pain were found between the treatment groups. Discussion and Conclusion. Open kinetic chain and CKC leg extensor training in the early period after ACL reconstruction surgery do not differ in their immediate effects on anterior knee pain. Based on these findings, further studies are needed using different exercise dosages and patient groups.

scholarly journals Biomechanical Difference between Conventional Transtibial Single-Bundle and Anatomical Transportal Double-Bundle Anterior Cruciate Ligament Reconstruction Using Three-Dimensional Finite Element Model Analysis

2021 ◽  
Vol 10 (8) ◽  
pp. 1625
Author(s):  
Jae Gyoon Kim ◽  
Kyoung Tak Kang ◽  
Joon Ho Wang
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Knee Flexion ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Element Model ◽  
Double Bundle ◽  
Contact Stresses ◽  
Single Bundle ◽  
Anterior Cruciate

The purpose of our study was to analyze the graft contact stress at the tunnel after transtibial single-bundle (SB) and transportal double-bundle (DB) anterior cruciate ligament (ACL) reconstruction. After transtibial SB (20 cases) and transportal DB (29 cases) ACL reconstruction, the three-dimensional image of each patient made by postoperative computed tomography was adjusted to the validation model of a normal knee and simulated SB and DB ACL reconstructions were created based on the average tunnel position and direction of each group. We also measured graft and contact stresses at the tunnel after a 134 N anterior load from 0° to 90° flexion. The graft and contact stresses became the greatest at 30° and 0° flexion, respectively. The total graft and contact stresses after DB ACL reconstruction were greater than those after SB ACL reconstruction from 0° to 30° and 0° to 90° knee flexion, respectively. However, the graft and contact stresses of each graft after DB ACL reconstruction were less than those after SB ACL reconstruction. In conclusion, the total graft and total contact stresses after DB ACL reconstruction are higher than those after SB ACL reconstruction from 0° to 30° and 0° to 90° knee flexion, respectively. However, the stresses of each graft after DB ACL reconstruction are about half of those after SB ACL reconstruction.

scholarly journals Comparison of Ultrasound-Guided Femoral and Infrapatellar Nerve Block Effects after Anterior Cruciate Ligament Repair Surgery

2020 ◽  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Patient Satisfaction ◽  
Acl Reconstruction ◽  
Nerve Block ◽  
Muscle Force ◽  
Cruciate Ligament ◽  
Ultrasound Guided ◽  
Reconstruction Surgery ◽  
The Mean ◽  
Anterior Cruciate

Background: There are various protocols for pain management after anterior cruciate ligament (ACL) reconstruction surgery. Objective: This study aimed to compare two blocking protocols, including femoral nerve block (FNB) and infrapatellar nerve block (IPNB) in terms of pain severity, patient satisfaction, and muscle force preservation. Materials and Methods: This single-blind clinical trial study investigated the patients who underwent elective knee arthroscopic ACL surgery randomly either by ultrasound-guided FNB or IPNB. Subsequently, the patients were evaluated 1, 3, 6, 12, and 24 h following NB for pain severity, patient satisfaction level, and muscle force. Results: The pain score (both at rest and in flexion) was significantly lower in the first three h after the intervention in the FNB group. Moreover, the mean score of the patients’ satisfaction in the first hours was significantly higher in the FNB group after the procedure. Additionally, the IPNB group obtained a significantly faster mean time required for the first dose of opioid request. The mean dose of used opioids over 24 h was significantly lower in the FNB group. There was a significant difference between the groups in terms of the muscle strength score within 24 h; moreover, the FNB group obtained a significantly greater delay in muscle recovery. Conclusion: The FNB is associated with greater pain relief and satisfaction in patients who underwent arthroscopic ACL reconstruction surgery, compared to the IFNB technique. However, a further delay in the recovery of quadriceps muscle force is evident in the FNB group.

scholarly journals Femoral tunnel in revision anterior cruciate ligament reconstruction

Joints ◽  
2013 ◽  
Vol 01 (03) ◽  
pp. 126-129 ◽  
Author(s):  
Francesco Giron ◽  
Michele Losco ◽  
Luca Giannini ◽  
Roberto Buzzi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Revision Surgery ◽  
Femoral Tunnel ◽  
Cruciate Ligament ◽  
Three Dimensional ◽  
Surgical Techniques ◽  
Dimensional Reconstruction ◽  
Sporting Activities ◽  
Anterior Cruciate

The failure rate after anterior cruciate ligament (ACL) reconstruction performed by expert surgeons is estimated to be in the range of 10-15%, and only 60% of patients undergoing this surgery are able to resume sporting activities comparable to those they engaged in prior to the traumatic incident.Incorrect femoral tunnel placement is one of the main causes of failed ACL reconstruction and this must be remembered when undertaking revision surgery.There are various possible errors that can be committed and, to plan revision surgery correctly, it is fundamental to study the position of the existing femoral tunnel(s) both on classic anteroposterior and lateral plain radiographs and on computed tomography scans with frontal, sagittal, and coronal sections, and also using three-dimensional reconstruction.In-depth anatomical knowledge and familiarity with the various possible surgical techniques are also mandatory for a successful surgical outcome.

The Effectiveness of a Functional Knee Brace on Joint-Position Sense in Anterior Cruciate Ligament–Reconstructed Individuals

2016 ◽  
Vol 25 (2) ◽  
pp. 190-194 ◽  
Author(s):  
Dai Sugimoto ◽  
Jessica C. LeBlanc ◽  
Sarah E. Wooley ◽  
Lyle J. Micheli ◽  
Dennis E. Kramer
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Position Sense ◽  
Joint Position Sense ◽  
Joint Position ◽  
Knee Brace ◽  
Reconstruction Surgery ◽  
Anterior Cruciate

It is estimated that approximately 350,000 individuals undergo anterior cruciate ligament (ACL) reconstruction surgery in each year in the US. Although ACL-reconstruction surgery and postoperative rehabilitation are successfully completed, deficits in postural control remain prevalent in ACL-reconstructed individuals. In order to assist the lack of balance ability and reduce the risk of retear of the reconstructed ACL, physicians often provide a functional knee brace on the patients’ return to physical activity. However, it is not known whether use of the functional knee brace enhances knee-joint position sense in individuals with ACL reconstruction. Thus, the effect of a functional knee brace on knee-joint position sense in an ACL-reconstructed population needs be critically appraised. After systematically review of previously published literature, 3 studies that investigated the effect of a functional knee brace in ACL-reconstructed individuals using joint-position-sense measures were found. They were rated as level 2b evidence in the Centre of Evidence Based Medicine Level of Evidence chart. Synthesis of the reviewed studies indicated inconsistent evidence of a functional knee brace on joint-position improvement after ACL reconstruction. More research is needed to provide sufficient evidence on the effect of a functional knee brace on joint-position sense after ACL reconstruction. Future studies need to measure joint-position sense in closed-kinetic-chain fashion since ACL injury usually occurs under weight-bearing conditions.

scholarly journals The Effect of Platelet Rich Plasma (PRP) in Anterior Cruciate Ligament (ACL) Reconstruction Surgery

2017 ◽  
Vol 30 ◽  
pp. 97-102
Author(s):  
Dwikora Novembri Utomo ◽  
Purwati ◽  
Damayanti Tinduh ◽  
Nanang Hari Wibowo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Knee Joint ◽  
Acl Reconstruction ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Reconstruction Surgery ◽  
Structure Degradation ◽  
Significant Difference ◽  
Anterior Cruciate ◽  
Proprioceptive Function

A torn in anterior cruciate ligament (ACL) caused by interference with the proprioceptive function of the knee joint can result in decreased function and other joint structure degradation that ultimately affect to daily activities. Platelet rich plasma (PRP) is widely used in recent studies to improve the healing of soft tissue injuries because it contains a lot of growth factor. This study was to determine the effect of platelet rich plasma in ACL reconstruction surgery. ACL reconstruction patients either with or without PRP were evaluated with Joint Position Sense (JPS) and Threshold To Detection of Passive Motion (TTDPM) measurements and the results were compared. From this study found 20 patients who had ACL reconstruction performed either with or without PRP. The test results showed statistically significant differences JPS in patients with ACL reconstruction who given PRP and not, at angle of 30˚ (p=0,037) and 45˚ (p=0,034). It also obtained a non-significant difference TTDPM in both groups (p=0,172). The conclusion obtained in this study is the addition of platelet rich plasma in patients with ACL reconstruction of knee joint can improve the function of JPS at an angle of 30˚ and 45˚, while the function of TTDPM is not increased significantly.

scholarly journals Effects of inclusion of proprioception training in the recovery of adults submitted to anterior cruciate ligament reconstruction surgery: a systematic review

2020 ◽  
Vol 31 (1) ◽  
Author(s):  
Wdson Donizete Da Silva Costa ◽  
Flávio Ricardo Guilherme ◽  
Stevan Ricardo Dos Santos ◽  
Eduardo Gauze Alexandrino ◽  
Vânia Renata Guilherme ◽  
...  
Keyword(s):  
Young Adults ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Reconstruction Surgery ◽  
Proprioceptive Training ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) rupture is an injury in young adults, triggering undesirable neuromuscular effects. A rehabilitation program is structured with exercises that aid in intensive care training, and proprioceptive training has been proposed as one of the training / rehabilitation methods in patients undergoing ACL reconstruction. Thus, this study aimed to analyze, through a systematic literature review, the effects of including proprioceptive training on different outcomes (stability / balance, proprioception, strength, functional capacity, coordination) after ACL reconstruction surgery in young adults. The search of the articles included studies in the last ten years, being a search conducted in November 2018. Searches were conducted in the electronic databases of PubMed and Science Direct with a following search methodology: (("Proprioception" [Mesh] ) OR "Proprioception" [Word Text]) AND ("Anterior Cruciate Ligament" [Mesh] OR "Anterior Cruciate Ligament Reconstruction" [Mesh] OR "Anterior Cruciate Ligament Injury" [Mesh]). Six studies were selected for the analysis and the results obtained there is insufficient scientific evidence showing the positive effects of training in proprioceptive training after ACL reconstruction in adults, in view of a shortage of studies, such as discrepancies in findings, without time of intervention and in the tests contracted in the analysis of the variables.

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