scholarly journals Arteriovenous Fistula after Anatomic All-Inside Anterior Cruciate Ligament Reconstruction

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Mathijs C. H. W. Fuchs ◽  
Martijn Dietvorst ◽  
Roel Vaes ◽  
Maarten Loos ◽  
Matthijs P. Somford ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Arteriovenous Fistula ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
First Case ◽  
Genicular Artery ◽  
Stab Incision ◽  
Anterior Cruciate ◽  
Lateral Superior Genicular Artery

We present the first case of an arteriovenous fistula after an all-inside anterior cruciate ligament (ACL) reconstruction. A seventeen-year-old boy had an uneventful ACL reconstruction. Four weeks after surgery, the patient was seen with a pulsating swelling at the lateral distal upper leg. Vascular consultation led to the diagnosis of pseudoaneurysm and arteriovenous fistula of the lateral superior genicular artery. Most likely, fistula is caused by the stab incision for preparation of the femoral tunnel, and no anatomical cause was found. The clinical presentation, previous cases of arteriovenous fistula after arthroscopic ACL reconstruction, possible causes, and management are discussed.

Perioperative Opioid Use in Anterior Cruciate Ligament Reconstruction Patients

2021 ◽  
Author(s):  
Ali Aneizi ◽  
Elizabeth Friedmann ◽  
Leah E. Henry ◽  
Gregory Perraut ◽  
Patrick M. J. Sajak ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Opioid Prescription ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

AbstractAnterior cruciate ligament reconstruction (ACLR) is one of the most commonly performed outpatient orthopaedic procedures, yet there is little data about perioperative opioid prescribing practices. The purposes of this study were to quantify the perioperative opioid prescriptions filled by patients who underwent ACLR and to identify factors associated with greater postoperative opioid use. Patients who underwent ACLR at a single institution between June 2015 and May 2017 were studied using a regional prescription monitoring database to identify all preoperative and postoperative outpatient opioid prescriptions up to 2 years postoperatively. The number of morphine milligram equivalents of each opioid was calculated to determine total morphine milligram equivalents (TMEs) filled preoperatively, at discharge, and refilled postoperatively. Patients who refilled an opioid prescription postoperatively were compared with those who did not. Ninety-nine of 269 (36.8%) total patients refilled an opioid prescription postoperatively. Thirty-three patients (12.3%) required a refill after 2 weeks postoperatively, and no patients refilled after 21 months postoperatively. Fifty-seven patients (21%) received an opioid prescription in the 2 years following surgery that was unrelated to their ACL reconstruction. Increased age, higher body mass index (BMI), government insurance, current or prior tobacco use history, preoperative opioid use, and greater number of medical comorbidities were significantly associated with refilling a prescription opioid. Higher BMI and government insurance were independent predictors of refilling. Higher preoperative TMEs and surgeon were independent predictor of greater refill TMEs. In the opioid-naïve subgroup of 177 patients, only higher BMI was a predictor of refilling, and only greater comorbidities was a predictor of greater refill TMEs. The results demonstrate that preoperative opioid use was associated with postoperative opioid refills and higher refill TMEs in a dose-dependent fashion. A higher percentage of patients received an opioid prescription for reasons unrelated to the ACL reconstruction than refilled a prescription after the first 2 weeks postoperatively.

Lower Leg Girth and Ankle Plantar-Flexor Endurance after Anterior Cruciate Ligament Reconstruction

2002 ◽  
Vol 11 (2) ◽  
pp. 128-138 ◽  
Author(s):  
Michael D. Ross ◽  
Shelly Hooten ◽  
Darren Moore
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Plantar Flexion ◽  
Lower Leg ◽  
Plantar Flexor ◽  
Rehabilitation Programs ◽  
Anterior Cruciate ◽  
The Relationship

Objective:To determine the relationship between asymmetries in lower leg girth and standing heel-rise after anterior cruciate ligament (ACL) reconstruction.Design:Single-group posttest.Participants:15 at a mean of 30 d after ACL reconstruction.Measurements:Lower leg girth and number of repetitions performed on the standing heel-rise test.Results:A significant decrease in lower leg girth and number of repetitions performed on the standing heel-rise test for the involved leg. There was also a low correlation between asymmetries in lower leg girth and standing heel-rise test (r= .25).Conclusion:Ankle plantar-flexor endurance should be considered when developing rehabilitation programs for the early stages after ACL reconstruction. In this study the ankle of the involved leg attained a significantly smaller angle of maximal standing plantar flexion, suggesting that ankle range of motion should also be assessed. Caution should be used in predicting standing heel-rise asymmetries from asymmetries in lower leg girth in ACL-reconstructed patients.

scholarly journals The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction

2018 ◽  
Vol 7 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Y. Sato ◽  
R. Akagi ◽  
Y. Akatsu ◽  
Y. Matsuura ◽  
S. Takahashi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Bone Healing ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Bone Tunnel ◽  
Femoral Bone ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Objectives To compare the effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament (ACL) reconstruction animal model. Methods Anterior cruciate ligament reconstruction using the plantaris tendon as graft material was performed on both knees of 24 rabbits (48 knees) to mimic ACL reconstruction by two different suspensory fixation devices for graft fixation. For the adjustable fixation device model (Socket group; group S), a 5 mm deep socket was created in the lateral femoral condyle (LFC) of the right knee. For the fixed-loop model (Tunnel group; group T), a femoral tunnel penetrating the LFC was created in the left knee. Animals were sacrificed at four and eight weeks after surgery for histological evaluation and biomechanical testing. Results Histologically, both groups showed a mixture of direct and indirect healing patterns at four weeks, whereas only indirect healing patterns were observed in both groups at eight weeks. No significant histological differences were seen between the two groups at four and eight weeks in the roof zone (four weeks, S: mean 4.8 sd 1.7, T: mean 4.5 sd 0.5, p = 0.14; eight weeks, S: mean 5.8 sd 0.8, T: mean 4.8 sd 1.8, p = 0.88, Mann-Whitney U test) or side zone (four weeks, S: mean 5.0 sd 1.2, T: mean 4.8 sd 0.4, p = 0.43; eight weeks, S: mean 5.3 sd 0.8,T: mean 5.5 sd 0.8, p = 0.61, Mann-Whitney U test) . Similarly, no significant difference was seen in the maximum failure load between group S and group T at four (15.6 sd 9.0N and 13.1 sd 5.6N) or eight weeks (12.6 sd 3.6N and 17.1 sd 6.4N, respectively). Conclusion Regardless of bone tunnel configuration, tendon-bone healing after ACL reconstruction primarily occurred through indirect healing. No significant histological or mechanical differences were observed between adjustable and fixed-loop femoral cortical suspension methods. Cite this article: Y. Sato, R. Akagi, Y. Akatsu, Y. Matsuura, S. Takahashi, S. Yamaguchi, T. Enomoto, R. Nakagawa, H. Hoshi, T. Sasaki, S. Kimura, Y. Ogawa, A. Sadamasu, S. Ohtori, T. Sasho. The effect of femoral bone tunnel configuration on tendon-bone healing in an anterior cruciate ligament reconstruction: An animal study. Bone Joint Res 2018;7:327–335. DOI: 10.1302/2046-3758.75.BJR-2017-0238.R2.

Evaluation of Local Cryotherapy after Anterior Cruciate Ligament Reconstruction. Critical Review of the Literature

2019 ◽  
Vol 21 (5) ◽  
pp. 319-328 ◽  
Author(s):  
Piotr Bednarski ◽  
Jerzy Kiwerski
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Early Period ◽  
Scientific Publications ◽  
Cruciate Ligament Reconstruction ◽  
Analgesic Effects ◽  
Anterior Cruciate

Background. At a time of innovative medical technologies development, it is paramount that medical services be evaluated with regard to their effectiveness. Research in physical medicine and rehabilitation, as well as the specialty itself, is relatively young; however, the number of publications in the field has recently been increasing. The main aim of this article is to evaluate the effectiveness of cryotherapy, including local cryostimulation, after anterior cruciate ligament reconstruction. Material and methods. The present paper reviews scientific publications extracted from the Medline Embase, Cochra­ne Library, and PEDro databases according to a pre-designed search strategy. The review analysed publications where the authors indicated cryotherapy as an intervention in patients after ACL reconstruction and the study endpoints referred to analgesic or anti-oedema effects. Results. As a result of selection, 16 publications were chosen for the analysis, including 1 meta-analysis, 2 systematic reviews and 13 RCTs. Only the results of randomised studies are presented. Endpoints referring to analgesic effects were present in all of the studies in the analysis, while endpoints referring to anti-oedema effects were present in five studies. Statistically significant results constituted 62% of the results for analgesic effects and 60% for anti-oedema effects. Conclusions. 1. The currently limited evidence from randomised studies is not sufficient to draw final conclusions on the effectiveness of cryotherapy in patients after anterior cruciate ligament reconstruction. 2. It seems that cryotherapy can serve as an adjunct analgesic treatment in the early period after arthroscopic ACL reconstruction, while there is no notable improvement in patients after this procedure in reducing oedema.

Clinical Outcome of Fixed Versus Adjustable Loop Cortical Suspension Devices in Arthroscopic Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 22 (3) ◽  
pp. 181-185
Author(s):  
Ramy Said Assaad Ahmed Mohamed ◽  
Mohamed Hossam El-Din El-Shafie ◽  
Mohamed Ahmed El-Sheikh
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Loop Group ◽  
Lysholm Score ◽  
Graft Fixation ◽  
Cruciate Ligament Reconstruction ◽  
Significant Difference ◽  
Anterior Cruciate

Background. Anterior cruciate ligament (ACL) reconstruction has remained the gold standard for ACL injuries, especially for young individuals and athletes exposed to high level sporting activities aiming to return to their preinjury level of activity. Cortical suspensory femoral fixation is commonly performed for graft fixation to the femur in anterior cruciate ligament reconstruction using hamstring tendons. The aim of this study was to compare the clinical results of using fixed and adjustable loop cortical suspension devices in arthroscopic ACL reconstruction using the Lysholm Knee Scoring Scale after 12 months postoperatively. Material and methods. This study included a total of sixty patients who underwent transportal arthroscopic ACL reconstruction using a hamstring tendon autograft from November 2016 to December 2017. For femoral graft fixation, a fixed-length loop device was used in 30 patients (fixed-loop group) and an adjustable-length loop device was used in 30 patients (adjustable-loop group) randomly.For tibial graft fixation, interference screw was used for all patients. Results. The present study shows that there was no statistically significant difference between the two groups regarding the Lysholm score with highly statistically significant difference between preoperative and postoperative Lysholm score in each group separately. Conclusion. Both fixed loop and adjustable loop devices in ACL reconstruction provided good clinical outcomes but without significant statistical difference between both groups from the clinical point of view postoperatively using the Lysholm score.

scholarly journals Anterior Cruciate Ligament Reconstruction Graft Options

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
Gustavo Vinagre ◽  
João Saraiva
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Knee Stability ◽  
Advantages And Disadvantages ◽  
Anterior Cruciate ◽  
Sports Traumatology ◽  
The Ideal

Introduction: The Anterior Cruciate Ligament (ACL) tear is one of the most feared injuries since it can be crucial in the athlete’s career. The ACL reconstruction is one of the most frequent surgical procedures in Sports and the goal is to restore knee stability and avoid further injuries on the meniscus and cartilage, representing a constant topic of debate in Sports Traumatology. There are different graft options for ACL reconstruction that have been described over the years, addressed by different studies with controversy and different outcomes. The decision of the ideal graft for an ACL reconstruction is very complex, but should be consensual among all those involved in the injury process, and should be taken according to patient´s anatomy, physical demand and intrinsic graft specifications, that are key to know and understand. Objectives: Review and summarize the different graft options available for ACL reconstruction in order to make an optimal and individualized choice for each athlete to maximize the return to play and back to Sports at pre-injury levels. Methods: A literature review was performed on PubMed / Medline electronic databases with the words “ACL graft” by relevance. The articles with graft comparisons specifications were selected. Results: The results of our review were summarized with the advantages and disadvantages of the following grafts: Bone-Tendon-Bone (BTB) autograft; hamstrings autograft, quadriceps autograft and allografts. Conclusion: Taking into account the scientific knowledge available and despite the differences in each graft, the choice of the ideal graft that should be used in the ACL reconstruction should be individualized for each athlete, according to intrinsic graft specifications and extrinsic particularities of each sport and athlete.

scholarly journals Results of meniscectomy and meniscal repair in anterior cruciate ligament reconstruction

Joints ◽  
2015 ◽  
Vol 03 (03) ◽  
pp. 151-157 ◽  
Author(s):  
Davide Deledda ◽  
Federica Rosso ◽  
Umberto Cottino ◽  
Davide Bonasia ◽  
Roberto Rossi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Medial Meniscus ◽  
Cruciate Ligament ◽  
Meniscal Repair ◽  
Meniscal Tears ◽  
Acl Injuries ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate

Meniscal tears are commonly associated with anterior cruciate ligament (ACL) injuries. A deficient medial meniscus results in knee instability and could lead to higher stress forces on the ACL reconstruction.Comparison of results in meniscectomy and meniscal repairs revealed worse clinical outcomes in meniscectomy, but higher re-operation rates in meniscal repairs. Our aim was to review the results of ACL reconstruction associated with meniscectomy or meniscal repair.

scholarly journals Lower Limb Asymmetry After Anterior Cruciate Ligament Reconstruction in Adolescent Athletes: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 55 (8) ◽  
pp. 811-825 ◽  
Author(s):  
Gerwyn Hughes ◽  
Perry Musco ◽  
Samuel Caine ◽  
Lauren Howe
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Reaction Force ◽  
Knee Extension ◽  
Cruciate Ligament Reconstruction ◽  
Peak Knee ◽  
Anterior Cruciate

Objectives To identify reported (1) common biomechanical asymmetries in the literature after anterior cruciate ligament (ACL) reconstruction in adolescents during landing and (2) timescales for asymmetry to persist postsurgery. Data Sources We identified sources by searching the CINAHL, PubMed, Scopus, and SPORTDiscus electronic databases using the following search terms: asymmetry OR symmetry AND landing AND biomechanics OR kinematics OR kinetics. Study Selection We screened the titles and abstracts of 85 articles using our inclusion criteria. A total of 13 articles were selected for further analysis. Data Extraction Three reviewers independently assessed the methodologic quality of each study. We extracted the effect sizes directly from studies or calculated them for biomechanical variables assessing asymmetry between limbs of participants with ACL reconstruction. We conducted meta-analyses on variables that were assessed in multiple studies for both double- and single-limb landings. Data Synthesis Asymmetry was more commonly identified in kinetic than kinematic variables. Anterior cruciate ligament reconstruction appeared to have a large effect on asymmetry between limbs for peak vertical ground reaction force, peak knee-extension moment, and loading rate during double-limb landings, as well as mean knee-extension moment and knee energy absorption during both double- and single-limb landings. Conclusions Our findings suggested that return-to-sport criteria after ACL reconstruction should incorporate analysis of the asymmetry in loading experienced by each limb rather than movement patterns alone.

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