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Journal articles on the topic 'Knee injuries'

Author: Grafiati

Published: 4 June 2021

Last updated: 1 August 2024

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1

Weber, Christian D., Lucian B. Solomon, Rolf Lefering, Klemens Horst, Philipp Kobbe, and Frank Hildebrand. "Which Risk Factors Predict Knee Ligament Injuries in Severely Injured Patients?—Results from an International Multicenter Analysis." Journal of Clinical Medicine 9, no. 5 (May 12, 2020): 1437. http://dx.doi.org/10.3390/jcm9051437.

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Introduction: Ligament injuries around the knee joint and knee dislocations are rare but potentially complex injuries associated with high-energy trauma. Concomitant neurovascular injuries further affect their long-term clinical outcomes. In contrast to isolated ligamentous knee injuries, epidemiologic data and knowledge on predicting knee injuries in severely injured patients is still limited. Methods: The TraumaRegister DGU® (TR-DGU) was queried (01/2009–12/2016). Inclusion criteria for selection from the database: maximum abbreviated injury severity ≥ 3 points (MAIS 3+). Participating countries: Germany, Austria, and Switzerland. The two main groups included a “control” and a “knee injury” group. The injury severity score (ISS) and new ISS (NISS) were used for injury severity classification, and the abbreviated injury scale (AIS) was used to classify the severity of the knee injury. Logistic regression analysis was performed to evaluate various risk factors for knee injuries. Results: The study cohort included 139,462 severely injured trauma patients. We identified 4411 individuals (3.2%) with a ligament injury around the knee joint (“knee injury” group) and 1153 patients with a knee dislocation (0.8%). The risk for associated injuries of the peroneal nerve and popliteal artery were significantly increased in dislocated knees when compared to controls (peroneal nerve from 0.4% to 6.7%, popliteal artery from 0.3% to 6.9%, respectively). Among the predictors for knee injuries were specific mechanisms of injury: e.g., pedestrian struck (Odds ratio [OR] 3.2, 95% confidence interval [CI]: 2.69–3.74 p ≤ 0.001), motorcycle (OR 3.0, 95% CI: 2.58–3.48, p ≤ 0.001), and motor vehicle accidents (OR 2.2, 95% CI: 1.86–2.51, p ≤ 0.001) and associated skeletal injuries, e.g., patella (OR 2.3, 95% CI: 1.99–2.62, p ≤ 0.001), tibia (OR 1.9, 95% CI: 1.75–2.05, p ≤ 0.001), and femur (OR 1.8, 95% CI: 1.64–1.89, p ≤ 0.001), but neither male sex nor general injury severity (ISS). Conclusion: Ligament injuries and knee dislocations are associated with high-risk mechanisms and concomitant skeletal injuries of the lower extremity, but are not predicted by general injury severity or sex. Despite comparable ISS, knee injuries prolong the hospital length of stay. Delayed or missed diagnosis of knee injuries can be prevented by comprehensive clinical evaluation after fracture fixation and a high index of suspicion is advised, especially in the presence of the above mentioned risk factors.

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2

Fanelli, Gregory C. "Timing of Repair or Reconstruction after Knee Dislocation." Journal of Knee Surgery 33, no. 04 (November 4, 2019): 335–38. http://dx.doi.org/10.1055/s-0039-1700573.

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AbstractThe multiple ligament injured knee (knee dislocation) is, often times, part of a multisystem injury complex that can include not only injuries to knee ligaments but also to blood vessels, skin, nerves, bones (fractures), head injuries, and other organ system trauma. These additional injuries can affect surgical timing for knee ligament reconstruction and also affect the results of the treatment. This article will present the author's approach and experience in the initial assessment and treatment of the acute multiple ligament injured (dislocated) knee, and also present considerations in the treatment of chronic multiple ligament injured knee.

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Marx, Robert G., and Isabel A. Wolfe. "ACL Reconstruction in the Multiple Ligament Injured Knee." Journal of Knee Surgery 33, no. 05 (December 3, 2019): 418–20. http://dx.doi.org/10.1055/s-0039-3400842.

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AbstractMultiple ligament knee injuries are complex and can result from sports injuries or high energy trauma. The proper diagnosis and treatment of multiple ligament knee injuries are essential, and careful evaluation and planning are required to achieve successful outcomes. Anterior cruciate ligament (ACL) reconstruction in the multiple ligament injured knee is complicated by several factors, necessitating additional technical considerations. Patient selection, surgical timing, graft selection, and surgical technique require consideration specific to the ACL component of these injuries. We present a summary of the current knowledge with respect to the treatment of ACL injuries in the context of the multiple ligament injured knee.

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Gadler, Tracie. "Knee Injuries." Advanced Emergency Nursing Journal 29, no. 3 (July 2007): 189–97. http://dx.doi.org/10.1097/01.tme.0000286962.94287.06.

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5

H.M. "Knee injuries." Journal of Science and Medicine in Sport 2, no. 1 (March 1999): 11. http://dx.doi.org/10.1016/s1440-2440(99)80063-2.

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6

&NA;. "Knee injuries." Nurse Practitioner 34, no. 7 (July 2009): 51–52. http://dx.doi.org/10.1097/01.npr.0000357250.08871.e7.

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7

Adams, Nicola. "Knee injuries." Emergency Nurse 11, no. 10 (March 2004): 19–27. http://dx.doi.org/10.7748/en2004.03.11.10.19.c1104.

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8

Soudbakhsh, Damoon, Elham Sahraei, Mehdi Bostan Shirin, Farzam Farahmand, Mohammad Naghi Tahmasebi, and Mohamad Parnianpour. "DIAGNOSING ANTERIOR CRUCIATE LIGAMENT INJURIES USING A KNEE ARTHROMETER: DESIGN, FABRICATION, AND CLINICAL EVALUATION." Biomedical Engineering: Applications, Basis and Communications 23, no. 03 (June 2011): 181–92. http://dx.doi.org/10.4015/s1016237211002517.

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Every year many people suffer from knee injuries. Previous studies on patients with knee injuries have shown that about 40% of knee injuries are Ligament injuries, and about 50% of the ligament injuries are the Anterior Cruciate Ligament (ACL) injuries. Along with other methods, knee arthrometers are widely used to diagnose ACL injuries. In the current research, a knee arthrometer was designed and developed to provide a reliable and repeatable measurement of knee laxity under anterior–posterior applied loads. Test–retest configurations to examine repeatability of the device resulted in less than 1.5-mm difference for more than 97% of tests under applied loads of up to 90 N. These tests included 166 tests on the left knees and 147 tests on the right knees of 37 healthy subjects. Also, this device was tested on 27 confirmed ACL ruptured patients, and the results were analyzed to find a better criterion than standard criteria to diagnose ACL rupture using knee arthrometers by finding specificity and sensitivity of the device using those criteria. Among the 20 criteria evaluated, a combination of side-to-side difference under 150 N of applied load, and CI@90-60 (compliance index calculated between 90 N, and 60 N) resulted in the best sensitivity (96.4%) and specificity (100%).

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Choubey, Amit, Rahul Dev Chauhan, and Sourabh Kumar. "Magnetic resonance imaging of post traumatic knee: injury pattern analysis in sports activities." International Journal of Research in Medical Sciences 10, no. 2 (January 29, 2022): 354. http://dx.doi.org/10.18203/2320-6012.ijrms20220057.

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Background: Musculoskeletal injuries of knee are commonly encountered in sportsmen during sports activities. Magnetic resonance imaging (MRI) is the modality of choice for evaluation of traumatic knee injuries and arthroscopic interventions. By knowing the pattern and burden of surgically significant injuries in sportsmen, the artificial intelligence (AI) software may be developed accordingly so that surgically significant injuries may be identified by the young radiologists. Methods: It was a retrospective study on MRI for knee injuries in sportsmen. The digital data from Radiology department at a zonal level hospital was analysed. The MRI findings were correlated with the arthroscopic records available. For surgically insignificant injuries, the literature was referred for the typical MRI findings of the injuries. Results: Of 272 cases of MRI knee, 74.3% cases were detected to have acute traumatic injuries. Among various types of injuries found in this study, anterior cruciate ligament (ACL) tear (55.9%) was the commonest injury followed by medial meniscal tear (40%). 40 (19.8%) cases were found to have surgically significant MRI findings which were subsequently corroborated with knee arthroscopy.Conclusions: Since majority of soft tissue injuries of knee constitute ACL and meniscal tears, the industries involved in developing AI software for soft tissue injuries of knee, should primarily focus on identification of ACL and meniscal injuries. The AI software may also be helpful for the young radiologists in early training days in MRI for knee injuries and may also help in big scale research projects of post traumatic MRI knees.

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Asghar, Maryam, Faryal Farooq, Kahkashan Hameed, Nazia Azeem, and Suresh Kumar. "Role of MRI to Determine Impact on Contralateral ACL/Meniscal Damage Secondary to Unilateral Traumatic Knee Injury in Adults." Annals of Punjab Medical College 17, no. 2 (September 27, 2023): 247–50. http://dx.doi.org/10.29054/apmc/2023.1308.

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Background: Knee injuries are one of the most common sports injuries and may cause chronic functional impairment. During a study in emergency department approximately 50% of injuries are caused by sports activities, with majority of the cases comprising of knee soft tissue injuries. The most common modality to diagnose musculoskeletal injury is magnetic resonance imaging nowadays. Knee injuries are one of the most frequently overlooked injuries and cause long term functional impairment. MRI provides the most effective and comprehensive imaging assessment of the knee joint and adjacent structures. Objective: To determine the significance of Magnetic resonance imaging (MRI) of contralateral uninjured knee in suspected meniscal/ACL injury of traumatic patients. Study Design: Prospective study. Settings: Radiology Department of Jinnah Postgraduate Medical Center (JPMC), Karachi Pakistan. Duration: January 2018 to December 2021. Methods: Patients aged 18 years or older who presented with a unilateral traumatic knee injury requiring medical evaluation and treatment and who underwent MRI evaluations for both the injured knee (ipsilateral) and the contralateral knee (opposite side) as part of their medical assessment were included. After taking informed consent, all patients underwent magnetic resonance imaging (MRI) examinations of both their affected (ipsilateral) and non-affected (contralateral) knee joints. These MRI findings were subjected to rigorous statistical analysis, which included comparisons between the affected and non-affected knees. Self-made proforma was used for the data collection. Results: According to our inclusion criteria, we identified 45 patients to participate in the study. Amongst these 82% of the patients were male and 17% were females, ratio between the male and female is 4.6:1. Mean age of the participants was found to be 38.64±14.4 years. Upon analysis, 62.2% of the patients had meniscal injury associated with ACL/PCL damage. While MRI findings were compared with contralateral normal side and found meniscal injury in 17(37.8%) cases, followed ACL/PCL injury 7(15.6%) and ACL/PCL injury associated meniscal injury ± effusion 7(15.6%) was (p = 0.004). Conclusion: MRI has proven to be a valuable imaging modality for identifying ligament tears and meniscal injuries of the knee joint in patients suspected of having meniscal/ACL injuries due to trauma. It not only assists in diagnosis but also provides valuable insights into the complexity of knee trauma.

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LaPrade, Robert F., Thomas J. Gilbert, Timothy S. Bollom, Fred Wentorf, and Gregory Chaljub. "The Magnetic Resonance Imaging Appearance of Individual Structures of the Posterolateral Knee." American Journal of Sports Medicine 28, no. 2 (March 2000): 191–99. http://dx.doi.org/10.1177/03635465000280020901.

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The purpose of this study was to contrast the magnetic resonance imaging appearance of uninjured components of the posterolateral knee with that of injured structures, and to assess the accuracy of magnetic resonance imaging in identifying posterolateral knee complex injuries. Thin-slice coronal oblique T1-weighted images through the entire fibular head were used to identify the posterolateral structures in seven uninjured knees. The appearance of corresponding grade III injuries to these structures was identified prospectively in 20 patients and verified at the time of surgical reconstruction. The sensitivity, specificity, and accuracy of imaging for the most frequently injured posterolateral knee structures in this series were as follows: iliotibial band-deep layer (91.7%, 100%, and 95%), short head of the biceps femoris-direct arm (81.3%, 100%, and 85%), short head of the biceps femoris-anterior arm (92.9%, 100%, and 95%), midthird lateral capsular ligament-meniscotibial (93.8%, 100%, and 95%), fibular collateral ligament (94.4%, 100%, and 95%), popliteus origin on femur (93.3%, 80%, and 90%), popliteofibular ligament (68.8%, 66.7%, and 68%), and the fabellofibular ligament (85.7%, 85.7%, and 85.7%). Magnetic resonance imaging of the knee was accurate in the identification of these injuries.

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Pardiwala, Dinshaw N., Kushalappa Subbiah, Raghavendraswami Thete, Ravikant Jadhav, and Nandan Rao. "Multiple ligament knee injuries: Clinical practice guidelines." Journal of Arthroscopic Surgery and Sports Medicine 3 (December 14, 2021): 40–49. http://dx.doi.org/10.25259/jassm_19_2021.

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Multiple ligament knee injuries involve tears of two or more of the four major knee ligament structures, and are commonly noted following knee dislocations. These devastating injuries are often associated with soft-tissue trauma, neurovascular deficit, and concomitant articular cartilage or meniscus tears. The complexity of presentation, and spectrum of treatment options, makes these injuries unique and extremely challenging to even the most experienced knee surgeons. A high level of suspicion, and a comprehensive clinical and radiological examination, is required to identify all injured structures. The current literature supports surgical management of these injuries, with cruciate reconstructions, and repair/augmented repair/ reconstruction of collateral ligaments. This review article analyses management principle of multiple ligament knee injuries, and formulates clinical practice guidelines with treatment algorithms essential to plan individualized management of these complex heterogeneous injuries.

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Subbiah, M., Vivek Pandey, Sharath K. Rao, and Sripathi Rao. "Staged Arthroscopic Reconstructive Surgery for Multiple Ligament Injuries of the Knee." Journal of Orthopaedic Surgery 19, no. 3 (December 2011): 297–302. http://dx.doi.org/10.1177/230949901101900307.

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Purpose. To review treatment outcome of our staged protocol for multiple ligament injuries of the knee. Methods. 21 men who were treated for multiple ligament injuries of the knee and had completed at least one year of rehabilitation were evaluated. Patients were examined under anaesthesia and then by diagnostic arthroscopy. Arthroscopic reconstructive procedures for injured cruciate ligaments were performed after a minimum 110° flexion and full extension were regained. Collateral ligaments injuries were treated first, followed by posterior cruciate ligament (PCL) and then anterior cruciate ligament (ACL) tears. Outcome was evaluated using the Lysholm knee score and International Knee Documentation Committee (IKDC) knee ligament evaluation form. Results. 19 patients aged 24 to 55 (mean, 36) years were followed up for a mean of 22 (range, 14–33) months. The mean Lysholm score was 92. The mean scores for patients treated within and after 3 weeks were 93 and 90, respectively. The overall IKDC grading was B in 15 knees and C and D each in 2 knees. For the 2 patients with grade D, one presented 19 months after the injury and had persistent posterior sag (secondary to capsular contracture). His Lysholm score was 82. The second patient developed a deep infection and endured a flexion loss of 30° but had a satisfactory Lysholm score of 94. There was no significant difference between early and delayed treatments and between low- and high-velocity injuries in terms of the Lysholm score, the IKDC grade, the range of movement, and the functional outcome. Conclusion. Staged management of multiple ligament injuries of the knee enabled satisfactory restoration of function, stability, and range of movement in most of our patients. By staging the procedures, the need for subsequent ACL reconstruction can be better evaluated, as ACL reconstruction is not necessary in patients not undertaking strenuous activities.

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Ristic, Vladimir, Sinisa Ristic, Mirsad Maljanovic, Vladimir Djan, Vukadin Milankov, and Vladimir Harhaji. "Risk factors for bilateral anterior cruciate ligament injuries." Medical review 68, no. 5-6 (2015): 192–97. http://dx.doi.org/10.2298/mpns1506192r.

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Introduction. The aim of this study has been to identify which risk factors can influence bilateral anterior cruciate ligament injury. Material and Methods. Thirty-two operated patients took part in this survey during the period of ten years. There were 5 women and 27 men, with average age of 30.46 years (19-55). The respondents filled in the questionnaire by answering the questions regarding the time when getting injured and operated, mechanism of injuries, genetic and anthropometric data, characteristics of sports and every day activities. Results. The incidence of reconstructed bilateral injuries in relation to unilateral ones was 2.3% (50/2168). The age of respondents and side of the injured knee did not correlate significantly with the achieved subjective physical activity level after the second knee surgery. The average time from the first injury to operation was 10 months and 4.3 years since that moment up to the injury of the other knee. It took more than 9 months on average until the reconstruction of contralateral anterior cruciate ligament. The most of athletes were injured in football matches. Three-quarters of athletes returned to competition activities after the first operation, which caused the same injury of the contralateral knee. Discussion and Conclusion. Anterior cruciate ligament rupture of the contralateral knee most often occurs in young active athletes within the first four years after the initial reconstruction. Its frequency is not affected by sex, side of extremity, genetic predisposition, type of sport, concomitant injuries and the choice of graft. Returning to the same or higher level of sports activities after the first reconstruction is one of the preconditions for injuring the other knee in the same way.

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Görmeli, Gökay, Cemile Ayşe Görmeli, Nurzat Elmalı, Mustafa Karakaplan, Kadir Ertem, and Yüksel Ersoy. "Outcome of the treatment of chronic isolated and combined posterolateral corner knee injuries with 2- to 6-year follow-up." Orthopaedic Journal of Sports Medicine 5, no. 2_suppl2 (February 1, 2017): 2325967117S0007. http://dx.doi.org/10.1177/2325967117s00078.

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Introduction: Injuries of the posterolateral corner (PLC) of the knee are rare. They are difficult to diagnose and can cause severe disability. This study presents the 20- to 70-month clinical and radiological outcomes of the anatomical reconstruction technique of LaPrade et al. Materials and methods Twenty-one patients with chronic PLC injuries underwent anatomical PLC reconstruction. The anatomical locations of the popliteus tendon, fibular collateral ligament, and popliteofibular ligament were reconstructed using a 2-graft technique. The patients were evaluated subjectively with the Tegner, Lysholm, and International Knee Documentation Committee (IKDC) subjective knee scores and objectively with the IKDC objective scores; additionally, varus stress radiographs were taken to evaluate knee stability. Results: Significant (p\0.05) improvements were observed in the postoperative Lysholm, IKDC-s, and Tegner scores compared with preoperatively. The IKDC objective subscores (lateral joint opening at 20_______________of knee extension, external rotation at 30_______________and 90_______________, and the reverse pivot-shift test) had improved significantly at the time of the final 40.9 ± 13.7-month follow-up.Lateralcompartment opening on the varus stress radiographs had decreased significantly in the postoperative period. However, there was still a significant difference compared with the uninjured knee. There was no significant improvement in the IKDC-s, Lysholm, or Tegner scores between the nine patients with isolated PLC injuries and twelve with multiligament injuries. Conclusions: Significant improvement in the objective knee stability scores and clinical outcomes with anatomical reconstruction showed that this technique can be used to treat patients with chronic PLC injured knees. However, longer-term multicentre studies and studies with larger groups comparing multiple techniques are required to determine the best treatment method for PLC injuries.

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Xiong, Yan, Xueliang Zhao, Hongyi Xiang, Yunjiao Wang, Zhikang Liao, Xiyan Zhu, and Hui Zhao. "Biomechanical Responses and Injury Characteristics of Knee Joints under Longitudinal Impacts of Different Velocities." Applied Bionics and Biomechanics 2018 (August 5, 2018): 1–11. http://dx.doi.org/10.1155/2018/1407345.

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Background and Objective. Knee joint collision injuries occur frequently in military and civilian scenarios, but there are few studies assessing longitudinal impacts on knee joints. In this study, the mechanical responses and damage characteristics of knee longitudinal collisions were investigated by finite element analysis and human knee impact tests. Materials and methods. Based on a biocollision test plateau, longitudinal impact experiments were performed on 4 human knee joints (2 in the left knee and 2 in the right knee) to measure the impact force and stress response of the bone. And then a finite element model of knee joint was established from the Chinese Visible Human (CVH), with which longitudinal impacts to the knee joint were simulated, in which the stress response was determined. The injury response of the knee joint-sustained longitudinal impacts was analyzed from both the experimental model and finite element analysis. Results. The impact experiments and finite element simulation found that low-speed impact mainly led to medial injuries and high-speed impact led to both medial and lateral injuries. In the knee joint impact experiment, the peak flexion angles were 13.8° ± 1.2, 30.2° ± 5.1, and 92.9° ± 5.45 and the angular velocities were 344.2 ± 30.8 rad/s, 1510.8 ± 252.5 rad/s, and 9290 ± 545 rad/s at impact velocities 2.5 km/h, 5 km/h, and 8 km/h, respectively. When the impact velocity was 8 km/h, 1 knee had a femoral condylar fracture and 3 knees had medial tibial plateau fractures or collapse fractures. The finite element simulation of knee joints found that medial cortical bone stress appeared earlier than the lateral peak and that the medial bone stress concentration was more obvious when the knee was longitudinally impacted. Conclusion. Both the experiment and FE model confirmed that the biomechanical characteristics of the injured femur and medial tibia are likely to be damaged in a longitudinal impact, which is of great significance for the prevention and treatment of longitudinal impact injuries of the knee joint.

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Neumann, Randall D. "TRAUMATIC KNEE INJURIES." Primary Care: Clinics in Office Practice 19, no. 2 (June 1992): 351–76. http://dx.doi.org/10.1016/s0095-4543(21)00141-x.

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Westrich, Geoffrey H., Steven B. Haas, and James V. Bono. "Occupational Knee Injuries." Orthopedic Clinics of North America 27, no. 4 (October 1996): 805–14. http://dx.doi.org/10.1016/s0030-5898(20)32125-8.

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19

Bach, Bernard R., and Warren B. Howe. "Acute Knee Injuries." Physician and Sportsmedicine 25, no. 5 (May 1997): 39–50. http://dx.doi.org/10.3810/psm.1997.05.1338.

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Noyes, Frank R. "Danielʼs Knee Injuries." Journal of Bone and Joint Surgery-American Volume 85, no. 12 (December 2003): 2494–95. http://dx.doi.org/10.2106/00004623-200312000-00048.

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LaPrade, Robert F., and Fred Wentorf. "Acute Knee Injuries." Physician and Sportsmedicine 27, no. 10 (October 1999): 55–61. http://dx.doi.org/10.1080/00913847.1999.11439361.

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Maffulli&NA;, Nicola, Kai Ming Chan, Michael Miao, Freddie H. Fu, and Masahiro Kurosaka. "Athletic Knee Injuries." Clinical Orthopaedics and Related Research 323 (February 1996): 98–105. http://dx.doi.org/10.1097/00003086-199602000-00013.

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Iobst, Christipher A., and Carl L. Stanitski. "ACUTE KNEE INJURIES." Clinics in Sports Medicine 19, no. 4 (October 2000): 621–35. http://dx.doi.org/10.1016/s0278-5919(05)70229-5.

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Blake, Matthew H., and Darren L. Johnson. "Knee Meniscus Injuries." Clinics in Sports Medicine 37, no. 2 (April 2018): 293–306. http://dx.doi.org/10.1016/j.csm.2017.12.007.

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Marom, Niv, Joseph J. Ruzbarsky, Naomi Roselaar, and Robert G. Marx. "Knee MLI Injuries." Clinics in Sports Medicine 37, no. 2 (April 2018): 281–91. http://dx.doi.org/10.1016/j.csm.2017.12.011.

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Jonides, Linda, Sally Walsh, and Carol Rudy. "Overuse knee injuries." Journal of Pediatric Health Care 7, no. 3 (May 1993): 134. http://dx.doi.org/10.1016/0891-5245(93)90094-x.

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Müller, W. "Knee ligament injuries." International Orthopaedics 20, no. 4 (July 29, 1996): 266–70. http://dx.doi.org/10.1007/s002640050076.

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Jakob. "Knee joint injuries." Therapeutische Umschau 57, no. 12 (December 1, 2000): 739–47. http://dx.doi.org/10.1024/0040-5930.57.12.739.

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Dank gezielter Untersuchungstechnik können die häufigsten Knieverletzungen schon in der Praxis klinisch und radiologisch erfasst werden: Die rezidivierende Patella Luxation anhand des «Apprehension sign»; die Meniskusläsion mit dem Zeichen nach McMurray, dem Schmerz am betroffenen Gelenkspalt und mit dem Hyperextensionsschmerz; die vordere Kreuzbandläsion mit dem Lachmanzeichen und dem Pivot Shift Phänomen, sowie die hintere Kreuzbandläsion mit dem dorsalen Durchhang der Tibia («Sag sign»). Der Einsatz weiterer bildgebender Verfahren gestattet eine definitive Diagnostik, die in vielen Fällen die klassische, rein diagnostische Arthroskopie überflüssig werden lässt. Ebenso kann dank der diagnostischen Punktion unter sterilen Kautelen die Zuweisung zum Traumatologen und Orthopäden gezielter erfolgen. Meniskusläsionen müssen nicht als Notfall operiert werden, es sei denn, das Kniegelenk sei blockiert. Auch bei der vorderen Kreuzbandruptur ist eine expektative Haltung über acht Wochen durchaus sinnvoll, wenn sie auch nur der Vorbereitung auf die Operation dient. Hintere Kreuzbandrupturen sollten nur von wenigen Zentren beurteilt und behandelt werden, da sie besondere Erfahrung erfordern. Das Gleiche gilt für die neuen Techniken zur Behandlung der Knorpelläsionen, sei es die Mosaikplastik oder die autologe Chondrozytenimplantation.

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Laurence, Michael. "Acute knee injuries." Journal of Bone and Joint Surgery. British volume 81-B, no. 5 (September 1999): 937. http://dx.doi.org/10.1302/0301-620x.81b5.0810937.

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Messer, Malynda S., Brendan Southam, and Brian M. Grawe. "Bilateral Multiligamentous Knee Injuries: A Case Report and Technique Review." Case Reports in Orthopedics 2018 (June 19, 2018): 1–8. http://dx.doi.org/10.1155/2018/3460153.

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Bilateral knee dislocations are rare musculoskeletal injuries. We report a case of a patient who sustained traumatic bilateral knee dislocations resulting in multiligamentous injuries to both knees. The patient subsequently underwent acute ligamentous reconstructions of both knees performed at 2 weeks and 3 weeks after the initial injury. One year after these procedures, the patient has achieved excellent functional outcomes and has returned to recreational sports.

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Jedvaj, Helena, Dalibor Kiseljak, and Olivera Petrak. "Kinesiophobia in Skiers with Knee Injuries." Polish Journal of Sport and Tourism 28, no. 1 (March 1, 2021): 24–29. http://dx.doi.org/10.2478/pjst-2021-0005.

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Abstract Introduction. Alpine skiing is one of the most dangerous winter sports that entails a high number of injuries, most commonly affecting the knee. Kinesiophobia is a condition in which an individual experiences fear of physical movement and activity as a result of feeling susceptible to injuries or recurrent injuries. The objective was to examine the level of kinesiophobia in skiers who have sustained knee injuries. Material and methods. The sample consisted of 22 female and 11 male professional skiers, with the average age of 24 ± 7.391 years. For the purpose of the assessment, the Tampa scale for kinesiophobia (TSK) was employed. Results. The number of knee injuries in skiers totals at least 1 and 11 at most, on average 2.45, most commonly involving the anterior cruciate ligament and meniscus. There were no significant differences between the left and the right knee or bilateral injuries. The average score in the TSK totals 36 points, which is close to the critical threshold of 37 points. 36% of the participants possess a high level of kinesiophobia. With respect to the general level of kinesiophobia, no significant differences were found in relation to gender, with regard to the number of surgeries or whether one or both knees were affected by injuries. Older skiers have also been found to have significantly lower fear of recurrent injuries. Conclusions. The number of knee injuries in skiing is high and aggravating, in such a way that almost one third of skiers that have sustained knee injuries experience a critical level of kinesiophobia, and that requires intervention. During rehabilitation, psychological support should also be provided to athletes in order to prevent or reduce kinesiophobia and thus prevent recurrent or new injuries.

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Rethnam, U., and R. Nair. "Knee injuries in the floating knee." Injury Extra 40, no. 10 (October 2009): 194. http://dx.doi.org/10.1016/j.injury.2009.06.202.

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Whiting, Nicole DeAvilla. "The Role of Yoga Therapy in Knee Rehabilitation." International Journal of Yoga Therapy 16, no. 1 (January 1, 2006): 79–94. http://dx.doi.org/10.17761/ijyt.16.1.c38k05v421p7124t.

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Therapeutic Yoga can be especially well-suited to aiding in the rehabilitation of knee injuries. This article discusses some common types of knee injuries and how Yoga can help rehabilitate some knee injuries. Specific âsanas for the knees are discussed, as well as how to work with the wellness of the whole person through âsana, prânâyâma, and meditation. Consideration is given to how Yoga therapists can work with other healthcare providers to improve the safety and efficacy of Yoga therapy. Two case studies of knee rehabilitation through Yoga therapy (one in a group class setting, and one in private Yoga therapy) are described, including details of the Yoga interventions that helped both individuals avoid surgical intervention.

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Nagib, Isa An. "Management of Multiligament Knee Injury." Orthopaedic Journal of Sports Medicine 11, no. 2_suppl (January 1, 2023): 2325967121S0085. http://dx.doi.org/10.1177/2325967121s00852.

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Multiligament knee injuries are defined as injuries to at least two of the four major ligaments in the knee: anterior cruciate ligament, posterior cruciate ligament, lateral collateral ligament (and posterolateral corner) and medial collateral ligament (and posteromedial corner). Multiple ligament knee injuries that results from high energy trauma, may have nerve and vascular injuries, therefore neurovascular examination with clear documentation of capillary refill time, distal pulses, function of all lower limb compartments and common peroneal and tibial nerve function should be performed. Before definitive treatment performed, we have to classified the multiligament injury according to the energy of the injury and the anatomic injured structures. MRI still recommended to know about the ligaments injury. The goal and our priority treatment is to obtain functional stability of the knee without the loss of motion or stiffnes that can lead to longterm pain, weakness, and the subsequent osteoarthritis.

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Makuch, Rafal, Adam Kucharski, Konrad Pilarski, Alicja Chrościcka, Kamil Gała, Andrzej Czajka, Paweł Lenard, Sara Michalska, Martyna Dewicka, and Alicja Maria Wawrzyniak. "Knee joint injuries in football players: types of injuries, etiology, diagnostics and prevention." Quality in Sport 15 (July 4, 2024): 51945. http://dx.doi.org/10.12775/qs.2024.15.51945.

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Introduction Football stands as the most widely embraced organized sport globally, boasting a staggering participation of over 200 million males and 21 million females officially registered under the auspices of the Fèdèration Internationale de Football Association (FIFA). Knee injuries are one of the most common health issues among soccer players at various levels of expertise. They arise from the intense nature of the game, which requires quick turns, running, jumping, kicking, and sudden changes in direction. These stresses can lead to strains and injuries in the structures of the knee joint, including ligaments, meniscus, tendons, and other soft tissues. This study gathers information about the most common types of knee injuries in soccer players, including situations in which these injuries occur, methods of diagnosis, treatment options, and strategies for injury prevention. Aim The aim of this study is to gather and analyse the studies about knee injuries in soccer players at various levels of expertise. Materials and Methods Review and summary of research studies available in databases on Google Scholar and PubMed. Databases such as PubMed and Google Scholar were searched using the keywords: ‘soccer knee injuries’, ‘soccer injuries’, ‘ACL tear’, ‘MCL injury’, ‘meniscus injury’, ‘PCL and LCL tear’. Summary Soccer, as a high-contact sport, inherently carries a significant risk of various injuries, particularly to the knees. The prevalence of knee injuries, such as ACL, MCL, and meniscus tears, underscores the importance of effective prevention strategies. Proper warm-ups and specialized preventive exercises, such as those in the FIFA 11+ program, are crucial in reducing the incidence of these injuries. Injuries can severely impact a player's career, leading to long-term health consequences. Therefore, timely and accurate diagnosis, along with appropriate treatment, is essential for recovery and career longevity.

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Ammar, Ameni, Oussama Abcha, and Mohamed Samir Daghfous. "Iatrogenic injuries of the popliteus tendon during total knee arthroplasty." Orthopaedic Journal of Sports Medicine 9, no. 6_suppl2 (June 1, 2021): 2325967121S0018. http://dx.doi.org/10.1177/2325967121s00189.

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Introduction: The popliteus tendon is known to play a key role in the stability of the posterolateral corner of the knee. Its role in the stability of the replaced knee remains contentious. Objectives: The aim of this study was to determine the impact of an iatrogenic lesion of the popliteus tendon during total knee arthroplasty surgery on the stability and function of the knee Methods: We searched in the operating report registers, patients with complete iatrogenic injury of the popliteus tendon during total knee arthroplasty on genu-varum. We evaluated postoperative varus, mobility and stability and we calculated their International Knee Society scores Results: Among the 423 reports of total knee arthroplasties consulted in the operating report registers, we found seven patients with a complete iatrogenic injury of the popliteus tendon. All patients had preoperative extension deficit. All operated knees were stiff, tight and small. At postoperative follow-up, all the knees had good stability and function. All the patients were satisfied. Conclusion: we concluded that the isolated section of the popliteus tendon does not seem to modify the static stability of the knee. However, it can cause a decrease in long-term functional scores. More work is needed to increase understanding of the impact of this iatrogenic lesion on long-term function.

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Steinberg, Nili, Itzhak Siev-Ner, Smadar Peleg, Gali Dar, Youssef Masharawi, Aviva Zeev, and Israel Hershkovitz. "Injuries in Female Dancers Aged 8 to 16 Years." Journal of Athletic Training 48, no. 1 (January 1, 2013): 118–23. http://dx.doi.org/10.4085/1062-6050-48.1.06.

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Context Most studies of injured dancers have been carried out on professional adult dancers; data on young, nonprofessional injured dancers are sparse. Objective To identify the types of injuries sustained by recreational dancers and to examine their association with age, joint range of motion, body structure, age at menarche, presence of anatomic anomalies, and physical burden (ie, practice hours en pointe). Design Descriptive epidemiology study. Setting The Israel Performing Arts Medicine Center, Tel Aviv. Patients or Other Participants A total of 569 injured female dancers, aged 8 to 16 years. Main Outcome Measure(s) Dependent variables were 61 types of current injuries that were later classified into 4 major categories: knee injuries, foot and ankle tendinopathy, back injuries, and other injuries. Independent variables were age, joint range of motion, body size and shape, age at menarche, anatomic anomalies, and dance discipline (eg, hours of practice per week en pointe). Results At least 1 previous injury had been sustained by 42.4% of the dancers. The most common injuries involved the knee (40.4%), followed by other injuries (23.4%). The relative frequency of back injuries and tendinopathy decreased with age, whereas knee injuries increased. Types of injuries were significantly associated with ankle plantar flexion, hip external rotation, hip abduction, and knee flexion. Multinomial regression analysis revealed only 3 predictive variables (with other as baseline), all for back injury: scoliosis, age, and hip external rotation. Conclusions Joint range of motion and scoliosis may signal the potential for future injury. Young dancers (less than 10 years of age) should not be exposed to overload (especially of the back) or extensive stretching exercises.

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CATAN, Liliana, and Marius NEGRU. "Physical therapy in adolescents with knee injuries treated with arthroscopy: our experience and literature review." Balneo Research Journal 11, Vol.11, no.3 (September 2, 2020): 294–98. http://dx.doi.org/10.12680/balneo.2020.355.

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If not treated adequately, the knee injuries in adolescents can cause long-term functional impairments. The aim of our study was to quantify the functioning capacity in children who suffered soft tissues and/or bone lesions of the knee treated by arthroscopy. We reviewed the medical charts of 5 adolescent patients diagnosed with sport knees injuries, admitted in our clinic in the last two years. Arthroscopy was made three weeks after the injury. Afterwards, they were addressed to the Rehabilitation Department and followed the physical exercise programme. The patients were assessed at the beginning of rehabilitation and after 3 months: knee ROM (flexion and extension deficit) and International Knee Documentation Committee (IKDC) subjective evaluation. At the final assessment all patients presented significantly improvements in knee range of motion and functional capacity. Arthroscopic surgery, followed by a tailored rehabilitation programme, is important in the management of adolescents with knee injuries.

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Takata, Yasushi, Junsuke Nakase, Tatsuhiro Toratani, Hitoaki Numata, Takeshi Oshima, Katsuhiko Kitaoka, and Hiroyuki Tsuchiya. "Conscious performance and arthroscopic findings in athletes with anterior cruciate ligament injuries treated via conservative therapy during the competitive season." Journal of Orthopaedic Surgery 25, no. 1 (January 1, 2017): 230949901668475. http://dx.doi.org/10.1177/2309499016684751.

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Purpose: Athletes often receive conservative treatment for injured anterior cruciate ligaments (ACLs) so that they can continue to play to the end of their season. The purpose of this study was to examine the conscious performance and arthroscopic findings of athletes who received conservative therapy for ACL injuries. Methods: Forty-two patients with ACL injuries underwent conservative treatment. After the season ended, ACL reconstruction was performed. We examined the following parameters: (1) time required for return to competition after injury, (2) conscious performance after return to competition, (3) whether the injured knee gave way during conservative therapy or after return to competition, and (4) cause of performance deterioration if applicable. To determine conscious performance, patients were asked to rate their performance after therapy relative to their performance before injury. Results: Thirty-eight of the 42 patients (90.5%) returned to competition after conservative treatment. The mean time to return was 13.8 ± 7.6 weeks, and the mean conscious performance score was 58.4 ± 16.5%. Thirty-eight patients (90.5%) experienced their knee giving way, of whom 36 (94.9%) stated that fear of their knee giving way hampered their performance. At the time of ACL reconstruction, 9 patients had chondral injuries and 22 patients had meniscus injuries. Conclusion: Most athletes with damaged ACLs returned to the field within the same season after conservative treatment. However, conscious performance was only about 60%. It is possible that knees giving way caused secondary meniscus and joint cartilage damage. Therefore, conservative treatment of individuals with ACL injuries should be considered carefully.

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Teitz, Carol C. "Hip and Knee Injuries in Dancers." Journal of Dance Medicine & Science 4, no. 1 (March 2000): 23–29. http://dx.doi.org/10.1177/1089313x0000400105.

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Common hip injuries in dancers include tendon problems, stress fractures, and torn acetabular labra. Problems in the knee are frequently related to patellar alignment, inflamed plicae, or torn menisci. Ligament injuries are less common in dancers but are discussed as well since their management differs from that in other athletes. Emphasis is placed on identifying technical errors and anatomical variations that may have contributed to the injuries. Recommendations for rehabilitating the injured dancer often include changes in technique in order to maximize the chances for full recovery and minimize the risk for the recurrence of the injury.

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Fanelli, David, and Gregory Fanelli. "Multiple Ligament Knee Injuries." Journal of Knee Surgery 31, no. 05 (March 13, 2018): 399–409. http://dx.doi.org/10.1055/s-0038-1636910.

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AbstractThe posterior cruciate ligament (PCL)-based multiple ligament injury, or dislocated knee, is often part of a multisystem injury complex that not only includes the knee ligaments, but may also include blood vessels, skin, nerves, fractures, and other organ system trauma. These factors must be considered in the scope of treating this complex knee injury. These complex knee ligament injuries can result in significant functional instability for the affected individual. This article will discuss multiple ligament knee injuries evaluation, treatment, and special considerations in the pediatric and adolescent population.

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Westermann, Robert, Shane Cook, Natalie Glass, Ned Amendola, Brian Wolf, Matthew Bollier, and Jessica Hanley. "Factors Associated with Knee Stiffness following Surgical Management of Multiligament Knee Injuries." Journal of Knee Surgery 30, no. 06 (October 27, 2016): 549–54. http://dx.doi.org/10.1055/s-0036-1593624.

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AbstractPostoperative knee stiffness can influence outcomes following operative treatment of multiligament knee injuries (MLKIs). The purpose of this study was to evaluate patient and surgical factors that may potentially contribute to stiffness following surgery for MLKIs. All surgically managed MLKIs involving two or more ligaments over a 10-year period at a single level one trauma center were included in this study. A retrospective review was performed to gather objective data related to the development of knee stiffness after surgery. Patients were classified as “stiff” postoperatively if they (1) had a flexion contracture greater than 10 degrees, (2) failed to reach 120 degrees of flexion at final follow-up, or (3) underwent a manipulation under anesthesia with or without arthroscopic lysis of adhesions to improve range of motion. Patient and surgical factors were evaluated systematically to determine factors associated with stiffness. The mean age of the cohort was 27.6 years at the time of surgery and mean follow-up was 50 weeks. Overall, 26/121 (21.5%) knees were diagnosed with postoperative stiffness. In the acute postoperative phase, 17 patients underwent manipulation under anesthesia. There were no significant differences in age, body mass index, associated injuries, mechanism, external fixation use or surgical timing (acute vs. chronic) between stiff and normal knees. Factors associated with the development of postoperative stiffness included knee dislocation (p = 0.04) and surgical intervention on three or more ligaments (p = 0.04). Careful attention to postoperative rehabilitation regimens should be given to patients with knee dislocations and/or those undergoing reconstruction or repair of three or more injured ligaments. Surgeons may utilize spanning external fixation if necessary without increasing the rate of long-term stiffness. Further, acute surgery does not appear to influence rates of postoperative stiffness or the need for manipulation.

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Moldovan, I., S. Mureşan, S. T. Pop, C. Trimbitas, D. M. Iliescu, and Klara Brînzaniuc. "Clinical and etiopathological aspects of muscle and joint sports injuries." ARS Medica Tomitana 18, no. 4 (November 1, 2012): 179–83. http://dx.doi.org/10.2478/v10307-012-0033-7.

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Abstract This descriptive study was conducted on a group of 92 patients during January 2012 - December 2012, treated at the Sports Rehabilitation Department of NOVA VITA Medical Center, Tîrgu Mures. We investigated the incidence of muscle and joint injuries by age group, gender, region of the injured muscle and joint, type of sport. Football is the main sport practiced at a professional level, thus the leg is the most exposed body part to diseases at different levels and degrees, especially the ankle, knee and thigh with muscle damage and ligament injuries. Playing tennis at an amateur level can harm body parts like the shoulder and the elbow and can cause tendon and muscle injuries. The most affected region is the knee. Knee injuries are present in almost all sports. Nearly 40% of the injuries are ligament injuries.

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Rashid, Md Harun Are, Md Mizanur Rahman, Mohammad Shamsul Alam, Mohammad Rafiqul Islam Khan, Md Fahim Hossain, and Md Sharif Bulbul. "Arthroscopic Evaluation of Association of Meniscus Injuries in Patients with Anterior Cruciate Ligament Injuries." Scholars Journal of Applied Medical Sciences 12, no. 03 (March 9, 2024): 245–50. http://dx.doi.org/10.36347/sjams.2024.v12i03.005.

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Background: The knee joint's stability relies significantly on the integrity of the meniscus and the anterior cruciate ligament (ACL). Chronic ACL tears can compromise knee stability, making the meniscus a crucial stabilizer. Understanding the prevalence and patterns of meniscus injuries associated with chronic ACL tears is essential for effective management. Objective: This study aimed to assess the arthroscopic evaluation of association of meniscus injuries in patients with anterior cruciate ligament injuries. Method: A retrospective analysis was conducted on thirty-three patients diagnosed with ACL injuries at MuMCH between January 2021 and December 2023. Patients aged 18-50 with ACL injuries, with or without meniscus damage, were included. Clinical evaluations, knee MRI scans, and diagnostic knee arthroscopies were performed. The study evaluated meniscus injuries associated with chronic ACL injuries and assessed outcomes using the modified Lysholm score. Results: The study revealed a predominant occurrence of meniscus injuries (70%) among participants, with a majority falling within the 38-47 years age bracket (45.45%) and a male majority (60%). Sports and accidental injuries accounted for 40% each, while road traffic accidents contributed 20%. Lateral meniscus tears were the most prevalent (30.30%), followed by combined medial and lateral meniscus tears (33.33%). Posterior horn tears were predominant, particularly in the medial meniscus. Conclusion: The study highlights a high incidence of meniscus injuries associated with chronic ACL tears, with medial meniscus injuries prevailing over lateral tears. Posterior horn tears were predominant, emphasizing the medial meniscus's significant role in knee stability. These findings underscore the importance of early detection and appropriate management of meniscus injuries in chronic ACL-deficient knees to prevent degenerative changes and optimize patient outcomes.

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Kim, Taegyu, Eunkuk Kim, Du Ruofei, and Hokyung Choi. "The Effects of Injury Experience in Lower Extremities on Joint Range of Motion, Muscle Extensibility, and Dynamic Stability in Elite Volleyball Players." Korean Journal of Sport Science 34, no. 4 (December 31, 2023): 558–68. http://dx.doi.org/10.24985/kjss.2023.34.4.558.

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PURPOSE This study investigates the impact of injury experience on ankle dorsiflexion, quadriceps extensibility, and dynamic stability in elite adolescent and adult volleyball players.METHODS A total of 485 players (adolescents=337, adults=115) reported lower extremities injuries, with measurements taken for ankle dorsiflexion and quadriceps extensibility using the weight- bearing lunge test and Ely’s test, respectively. The Y-balance test was used for dynamic stability. Measurements were conducted on the injured leg of players with knee and/or ankle injuries and the dominant leg of healthy players. Four groups were classified based on injury experience, and comparisons were made between both legs. Additionally, the variables of adolescent players were compared to those of adults.RESULTS Adolescent players with knee injuries exhibited a larger difference in ankle dorsiflexion between both legs, while adult players with ankle injuries demonstrated an asymmetry of ankle dorsiflexion. Regardless of age, players with knee or ankle injuries displayed lower dynamic stability compared to healthy players. Notably, adults with knee injuries showed a larger difference in dynamic stability between both legs.CONCLUSIONS To prevent and rehabilitate volleyball-related injuries, comprehensive injury risk factors, including age, should be managed in the injury prevention strategies.

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Atkinson, Patrick J., and Roger C. Haut. "Impact Responses of the Flexed Human Knee Using a Deformable Impact Interface." Journal of Biomechanical Engineering 123, no. 3 (January 11, 2001): 205–11. http://dx.doi.org/10.1115/1.1372320.

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Blunt impact trauma to the patellofemoral joint during car accidents, sporting activities, and falls can produce a range of injuries to the knee joint, including gross bone fracture, soft tissue injury, and/or microinjuries to bone and soft tissue. Currently, the only well-established knee injury criterion applies to knee impacts suffered during car accidents. This criterion is based solely on the peak impact load delivered to seated cadavers having a single knee flexion angle. More recent studies, however, suggest that the injury potential, its location, and the characteristics of the damage are also a function of knee flexion angle and the stiffness of the impacting structure. For example, at low flexion angles, fractures of the distal patella are common with a rigid impact interface, while at high flexion angles splitting of the femoral condyles is more evident. Low stiffness impact surfaces have been previously shown to distribute impact loads over the anterior surface of the patella to help mitigate gross and microscopic injuries in the 90 deg flexed knee. The objective of the current study was to determine if a deformable impact interface would just as effectively mitigate gross and microscopic injuries to the knee at various flexion angles. Paired experiments were conducted on contralateral knees of 18 human cadavers at three flexion angles (60, 90, 120 deg). One knee was subjected to a fracture level impact experiment with a rigid impactor, and the opposite knee was impacted with a deformable interface (3.3 MPa crush strength honeycomb material) to the same load. This (deformable) impact interface was effective at mitigating gross bone fractures at approximately 5 kN at all flexion angles, but the frequency of split fracture of the femoral condyles may not have been significantly reduced at 120 deg flexion. On the other hand, this deformable interface was not effective in mitigating microscopic injuries observed for all knee flexion angles. These new data, in concert with the existing literature, suggest the chosen impact interface was not optimal for knee injury protection in that fracture and other minor injuries were still produced. For example, in 18 cadavers a total of 20 gross fractures and 20 subfracture injuries were produced with a rigid interface and 5 gross fractures and 21 subfracture injuries with the deformable interface selected for the current study. Additional studies will be needed to optimize the knee impact interface for protection against gross and microscopic injuries to the knee.

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Bailey, M. E. A., R. Wei, S. Bolton, and R. H. Richards. "Paediatric injuries around the knee: Bony injuries." Injury 51, no. 3 (March 2020): 611–19. http://dx.doi.org/10.1016/j.injury.2019.12.033.

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Bates, Nathaniel A., Nathan D. Schilaty, Christopher V. Nagelli, Aaron J. Krych, and Timothy E. Hewett. "Validation of Noncontact Anterior Cruciate Ligament Tears Produced by a Mechanical Impact Simulator Against the Clinical Presentation of Injury." American Journal of Sports Medicine 46, no. 9 (June 4, 2018): 2113–21. http://dx.doi.org/10.1177/0363546518776621.

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Background: Anterior cruciate ligament (ACL) injuries are catastrophic events that affect athletic careers and lead to long-term degenerative knee changes. As injuries are believed to occur within the first 50 milliseconds after initial contact during a rapid deceleration task, impact simulators that rapidly deliver impulse loads to cadaveric specimens have been developed. However, no impactor has reproducibly and reliably created ACL injures in a distribution that mimics clinical observation. Purpose: To better understand ACL injury patterns through a cadaveric investigation that applied in vivo–measured external loads to the knee during simulated landings. Study Design: Controlled laboratory study. Methods: A novel mechanical impact simulator reproduced kinetics from in vivo–recorded drop landing tasks on 45 cadaveric knees. Specimens were exposed to a randomized order of variable knee abduction moment, anterior tibial shear, and internal tibial rotation loads before the introduction of an impulse load at the foot. This process was repeated until a hard or soft tissue injury was induced on the joint. Injuries were assessed by an orthopaedic surgeon, and ligament strain was recorded by implanted strain gauges. Results: The mechanical impact simulator induced ACL injuries in 87% of specimens, with medial collateral ligament (MCL) injuries in 31%. ACL tear locations were 71% femoral side, 21% midsubstance, and 9% tibial side. Peak strain before failure for ACL-injured specimens was 15.3% ± 8.7% for the ACL and 5.1% ± 5.6% for the MCL ( P < .001). Conclusion: The ACL injuries induced by the mechanical impact simulator in the present study have provided clinically relevant in vitro representations of in vivo ACL injury patterns as cited in the literature. Additionally, current ligament strains corroborate the literature to support disproportionate loading of the ACL relative to the MCL during athletic tasks. Clinical Relevance: These findings indicate that the mechanical impact simulator is an appropriate model for examining independent mechanical variables, treatment techniques, and preventive interventions during athletic tasks leading up to and including an ACL injury. Accordingly, this system can be utilized to further parse out contributing factors to an ACL injury as well as assess the shortcomings of ACL reconstruction techniques in a dynamic, simulated environment that is better representative of in vivo injury scenarios.

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Norouzi, Sadegh, Fateme Esfandiarpour, Ali Shakourirad, Reza Salehi, Mohammad Akbar, and Farzam Farahmand. "Rehabilitation after ACL Injury: A Fluoroscopic Study on the Effects of Type of Exercise on the Knee Sagittal Plane Arthrokinematics." BioMed Research International 2013 (2013): 1–7. http://dx.doi.org/10.1155/2013/248525.

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A safe rehabilitation exercise for anterior cruciate ligament (ACL) injuries needs to be compatible with the normal knee arthrokinematics to avoid abnormal loading on the joint structures. The objective of this study was to measure the amount of the anterior tibial translation (ATT) of the ACL-deficient knees during selective open and closed kinetic chain exercises. The intact and injured knees of fourteen male subjects with unilateral ACL injury were imaged using uniplanar fluoroscopy, while the subjects performed forward lunge and unloaded/loaded open kinetic knee extension exercises. The ATTs were measured from fluoroscopic images, as the distance between the tibial and femoral reference points, at seven knee flexion angles, from 0° to 90°. No significant differences were found between the ATTs of the ACL-deficient and intact knees at all flexion angles during forward lunge and unloaded open kinetic knee extension (). During loaded open kinetic knee extension, however, the ATTs of the ACL deficient knees were significantly larger than those of the intact knees at 0° (). It was suggested that the forward lunge, as a weight-bearing closed kinetic chain exercise, provides a safer approach for developing muscle strength and functional stability in rehabilitation program of ACL-deficient knees, in comparison with open kinetic knee extension exercise.

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Kujala, U. M., M. Kvist, and K. Österman. "Knee Injuries in Athletes." Sports Medicine 3, no. 6 (1986): 447–60. http://dx.doi.org/10.2165/00007256-198603060-00006.

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