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Articoli di riviste sul tema "Knee Reconstruction":
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Ishibashi, Yasuyuki, Eiichi Tsuda, Akira Fukuda, Harehiko Tsukada e Satoshi Toh. "Intraoperative Biomechanical Evaluation of Anatomic Anterior Cruciate Ligament Reconstruction Using a Navigation System". American Journal of Sports Medicine 36, n. 10 (3 settembre 2008): 1903–12. http://dx.doi.org/10.1177/0363546508323245.
Background Recently, more anatomic anterior cruciate ligament reconstructions have been developed to improve knee laxity. Purpose The objective of this study is to assess knee kinematics after double-bundle reconstruction with hamstring tendon and after anatomically oriented reconstruction with a patellar tendon using navigation during surgery. Study Design Cross-sectional study; Level of evidence, 3. Methods Eighty knees received double-bundle reconstruction with a hamstring tendon graft, and 45 knees received anatomically oriented reconstruction with a patellar tendon graft. Before reconstruction, knee laxity was measured using a navigation system. After the posterolateral bundle or anteromedial bundle was temporarily fixed during double-bundle reconstruction, knee laxity was measured to assess the function of each bundle. After double-bundle reconstruction or anatomically oriented reconstruction with patellar tendon, knee laxity was measured in the same manner. Results Both double-bundle reconstruction and anatomically oriented reconstruction similarly improved knee laxity compared With before reconstruction in all knee flexion angles. Regarding the function of the anteromedial and posterolateral bundles in double-bundle reconstruction, the 2 grafts showed contrasting behavior. The posterolateral bundle restrained tibial displacement mainly in knee extension, whereas the anteromedial bundle restrained it more in the knee flexion position. The posterolateral bundle has a more important role in controlling rotation of the tibia than the anteromedial bundle. Conclusion Although the posterolateral bundle has an important role in the extension position, the anteromedial bundle is more important in the flexion position. Therefore, both bundles should be reconstructed to improve knee laxity throughout knee range of motion. Even with single-bundle reconstruction using a patellar tendon, anatomic reconstruction might improve knee laxity similar to double-bundle reconstruction.
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Burkhart, Timothy A., Takashi Hoshino, Lachlan M. Batty, Alexandra Blokker, Philip P. Roessler, Rajeshwar Sidhu, Maria Drangova et al. "No Difference in Ligamentous Strain or Knee Kinematics Between Rectangular or Cylindrical Femoral Tunnels During Anatomic ACL Reconstruction With a Bone–Patellar Tendon–Bone Graft". Orthopaedic Journal of Sports Medicine 9, n. 6 (1 giugno 2021): 232596712110095. http://dx.doi.org/10.1177/23259671211009523.
Background: As our understanding of anterior cruciate ligament (ACL) anatomy has evolved, surgical techniques to better replicate the native anatomy have been developed. It has been proposed that the introduction of a rectangular socket ACL reconstruction to replace a ribbon-shaped ACL has the potential to improve knee kinematics after ACL reconstruction. Purpose: To compare a rectangular femoral tunnel (RFT) with a cylindrical femoral tunnel (CFT) in terms of replicating native ACL strain and knee kinematics in a time-zero biomechanical anatomic ACL reconstruction model using a bone–patellar tendon–bone (BTB) graft. Study Design: Controlled laboratory study. Methods: In total, 16 fresh-frozen, human cadaveric knees were tested in a 5 degrees of freedom, computed tomography–compatible joint motion simulator. Knees were tested with the ACL intact before randomization to RFT or CFT ACL reconstruction using a BTB graft. An anterior translation load and an internal rotation moment were each applied at 0°, 30°, 60°, and 90° of knee flexion. A simulated pivot shift was performed at 0° and 30° of knee flexion. Ligament strain and knee kinematics were assessed using computed tomography facilitated by insertion of zirconium dioxide beads placed within the substance of the native ACL and BTB grafts. Results: For the ACL-intact state, there were no differences between groups in terms of ACL strain or knee kinematics. After ACL reconstruction, there were no differences in ACL graft strain when comparing the RFT and CFT groups. At 60° of knee flexion with anterior translation load, there was significantly reduced strain in the reconstructed state ([mean ±standard deviation] CFT native, 2.82 ± 3.54 vs CFT reconstructed, 0.95 ± 2.69; RFT native, 2.77 ± 1.71 vs RFT reconstructed, 1.40 ± 1.76) independent of the femoral tunnel type. In terms of knee kinematics, there were no differences when comparing the RFT and CFT groups. Both reconstructive techniques were mostly effective in restoring native knee kinematics and ligament strain patterns as compared with the native ACL. Conclusion: In the time-zero biomechanical environment, similar graft strains and knee kinematics were achieved using RFT and CFT BTB ACL reconstructions. Both techniques appeared to be equally effective in restoring kinematics associated with the native ACL state. Clinical Relevance: These data suggest that in terms of knee kinematics and graft strain, there is no benefit in performing the more technically challenging RFT as compared with a CFT BTB ACL reconstruction.
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Chia, Zi-Yang, Jade N. Chee, Hamid Rahmatullah Bin-Abd-Razak, Denny TT Lie e Paul CC Chang. "A comparative study of anterior cruciate ligament reconstruction with double, single, or selective bundle techniques". Journal of Orthopaedic Surgery 26, n. 2 (1 maggio 2018): 230949901877312. http://dx.doi.org/10.1177/2309499018773124.
Purpose: Reconstruction of the anterior cruciate ligament (ACL) is the most frequently performed reconstructive surgery in the knee. Biomechanical studies have shown that double bundle (DB) reconstruction is better than single bundle (SB) reconstruction with regard to rotational stability. It is postulated that resection of ACL fibres that remain in continuity may be counterproductive for the knee as these fibres have the capacity to produce collagen. In this study, we aimed to evaluate the efficacy among selective bundle, DB and SB ACL reconstructions over a 2-year post-operative follow-up period. Methods: A retrospective comparative study was conducted for comparison between selective bundle, DB and SB reconstructions. Between 2012 and 2014, 291 ACL reconstructions were performed. Of these, 68 patients had selective ACL reconstructions (group SLB), 147 had DB ACL reconstructions (group DB) and 76 had SB ACL reconstructions (group SB). Institutional Review Board approval was obtained, and all patients provided informed consent. Clinical results were assessed with the International Knee Documentation Committee (IKDC), Lysholm and Tegner scores. Stability was measured using Lachman, pivot shift and anterior drawer stress tests using the KT1000 at 30° of knee flexion. Results: There was no significant difference in ligament grade, function grade, IKDC grade, as well as Tegner and Lysholm means among all three groups after a 2-year follow-up period. Conclusion: Selective bundle reconstruction provides comparable results to DB and SB reconstruction techniques. It is a viable alternative for patients with partial tears.
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Yagi, Masayoshi, Eric K. Wong, Akihiro Kanamori, Richard E. Debski, Freddie H. Fu e Savio L.-Y. Woo. "Biomechanical Analysis of an Anatomic Anterior Cruciate Ligament Reconstruction". American Journal of Sports Medicine 30, n. 5 (settembre 2002): 660–66. http://dx.doi.org/10.1177/03635465020300050501.
Background: The focus of most anterior cruciate ligament reconstructions has been on replacing the anteromedial bundle and not the posterolateral bundle. Hypothesis: Anatomic two-bundle reconstruction restores knee kinematics more closely to normal than does single-bundle reconstruction. Study Design: Controlled laboratory study. Methods: Ten cadaveric knees were subjected to external loading conditions: 1) a 134-N anterior tibial load and 2) a combined rotatory load of 5-N·m internal tibial torque and 10-N·m valgus torque. Resulting knee kinematics and in situ force in the anterior cruciate ligament or replacement graft were determined by using a robotic/universal force-moment sensor testing system for 1) intact, 2) anterior cruciate ligament deficient, 3) single-bundle reconstructed, and 4) anatomically reconstructed knees. Results: Anterior tibial translation for the anatomic reconstruction was significantly closer to that of the intact knee than was the single-bundle reconstruction. The in situ force normalized to the intact anterior cruciate ligament for the anatomic reconstruction was 97% ± 9%, whereas the single-bundle reconstruction was only 89% ± 13%. With a combined rotatory load, the normalized in situ force for the single-bundle and anatomic reconstructions at 30° of flexion was 66% ± 40% and 91% ± 35%, respectively. Conclusions: Anatomic reconstruction may produce a better biomechanical outcome, especially during rotatory loads. Clinical Relevance: Results may lead to the use of a two-bundle technique.
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Chernchujit, Bancha, Arrisna Artha e Panin Anilabol. "Comparative Biomechanical Study Between Minimally Invasive Popliteus and LCL Reconstruction Versus LaPrade Technique". Orthopaedic Journal of Sports Medicine 8, n. 5_suppl5 (1 maggio 2020): 2325967120S0009. http://dx.doi.org/10.1177/2325967120s00091.
Background: Many aspects of the posterolateral corner (PLC) of the knee have been extensively studied within the past 20 years. Quantitative anatomic and biomechanical studies have demonstrated the importance of the 3 static stabilizers of the lateral side of the knee: the fibular collateral ligament, the popliteus tendon, and the popliteofibular ligament. There are various methods of reconstruction. However, currently, there is no consensus on the preferred reconstruction technique for treating patients with chronic PLC injuries. We have developed a new reconstructive technique for PLC based on tibiofibular-based technique, similar to LaPrade, and this technique is less invasive than the previous techniques. Hypothesis: There is no difference between minimally invasive popliteus and LCL reconstruction and LaPrade’s method in restoring the posterolateral stability of knees Methods: Six paired fresh-frozen cadaveric knees were assessed in the intact state and then dissected to simulate a grade III posterolateral knee injury. By using a “Blocked randomization”, each paired knee was randomized into 2 groups (1) reconstruction via LaPrade’s method, (2) minimally invasive popliteus and LCL reconstruction. Biomechanical testing using varus stress radiographs was performed to compare knee stability between 2 groups. Results: This study included six paired knees, three males and three females. The mean age of the cadaver was 70.8 years (range 57-85 years). No difference was found in the demographic data (sex distribution, lateral opening gap of intact knee and side-to-side difference of lateral opening gap of sectioned knee) between the 2 groups. The side-to-side difference in lateral joint opening on the varus stress radiographs significantly improved after PLC reconstruction in both groups (p <0.001, p <0.001), However, there were no differences between the 2 groups in side-to-side difference of lateral opening gap after reconstruction (Mean difference=-0.05 (95%CI, -0.46 to 0.36); p- value=0.039). Conclusion: Biomechanically, minimally invasive popliteus and LCL reconstruction is equivalent to LaPrade’s technique in restoring the stability of knees in case of grade III PLC injury. Additionally, this technique is less invasive than all traditional open technique of PLC reconstruction. The minimally invasive popliteus and LCL reconstruction technique may be a treatment option for grade III PLC injury. Keywords: posterolateral corner; ligament reconstruction; popliteus tendon; lateral collateral ligament; popliteofibular ligament; knee biomechanics; minimally invasive surgery
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Sasaki, Yusuke, Masataka Fujii, Daisuke Araki, Brandon D. Marshall, Monica A. Linde, Patrick Smolinski e Freddie H. Fu. "Effect of Percentage of Femoral Anterior Cruciate Ligament Insertion Site Reconstructed With Hamstring Tendon on Knee Kinematics and Graft Force". American Journal of Sports Medicine 49, n. 5 (3 marzo 2021): 1279–85. http://dx.doi.org/10.1177/0363546521995199.
Background: Previous studies have stated that closely matching the size of the anterior cruciate ligament (ACL) insertion site footprint is important for biomechanical function and clinical stability after ACL reconstruction. However, the ACL varies widely regarding the area of femoral insertion, tibial insertion, and midsubstance of ACL, and reconstructing the insertion site area with a uniform diameter graft can result in a cross-sectional area that is greater than that of the midsubstance of the native ACL. Therefore, understanding the effect of relative graft size in ACL reconstruction on knee biomechanics is important for surgical planning. Purpose: To assess how the percentage of femoral insertion site affects knee biomechanics in single- and double-bundle ACL reconstruction. Study Design: Controlled laboratory study. Methods: A total of 14 human cadaveric knees were scanned with magnetic resonance imaging and tested using a robotic system under an anterior tibial load and a combined rotational load. In total, 7 knee states were evaluated: intact ACL; deficient ACL; single-bundle ACL reconstruction with approximate graft sizes 25% (small), 50% (medium), and 75% (large) of the femoral insertion site; and double-bundle reconstruction of approximately 50% (medium) and 75% (large) of the femoral insertion site, based on the ratio of the cross-sectional area of the graft to the area of the femoral ACL insertion site determined by magnetic resonance imaging. Results: Anterior tibial translation was not significantly larger than the intact state in single-bundle and double-bundle medium graft reconstructions ( P > .05) and was significantly greater in the single-bundle small graft reconstruction ( P < .05). Anterior knee translation in single-bundle medium graft and large graft reconstructions was not statistically different ( P > .05). In contrast, the anterior tibial translation for double-bundle large graft reconstruction was significantly smaller than for double-bundle medium graft reconstruction at low flexion angles ( P < .05). The single-bundle small graft force was significantly different from the intact ACL in situ force ( P < .05). The graft force with double-bundle large reconstruction was significantly greater than that with the double-bundle medium reconstruction ( P < .05) but was not significantly different from that of the intact ACL ( P > .05). Conclusion: Knee biomechanics with a single-bundle small graft tended to be significantly different from those of the intact knee. In the kinematic and kinetic data for the single- and double-bundle medium graft reconstruction, only the anterior translation at full extension for the single-bundle reconstruction was significantly different (lower) from that of intact knee. This was a time zero study. Clinical Relevance: This study can provide surgeons with guidance in selecting the graft size for ACL reconstruction.
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Nielsen, Emil Toft, Kasper Stentz-Olesen, Sepp de Raedt, Peter Bo Jørgensen, Ole Gade Sørensen, Bart Kaptein, Michael Skipper Andersen e Maiken Stilling. "Influence of the Anterolateral Ligament on Knee Laxity: A Biomechanical Cadaveric Study Measuring Knee Kinematics in 6 Degrees of Freedom Using Dynamic Radiostereometric Analysis". Orthopaedic Journal of Sports Medicine 6, n. 8 (1 agosto 2018): 232596711878969. http://dx.doi.org/10.1177/2325967118789699.
Background: An anterior cruciate ligament (ACL) rupture often occurs during rotational trauma to the knee and may be associated with damage to extracapsular knee rotation–stabilizing structures such as the anterolateral ligament (ALL). Purpose: To investigate ex vivo knee laxity in 6 degrees of freedom with and without ALL reconstruction as a supplement to ACL reconstruction. Study Design: Controlled laboratory study. Methods: Cadaveric knees (N = 8) were analyzed using dynamic radiostereometry during a controlled pivotlike dynamic movement simulated by motorized knee flexion (0° to 60°) with 4-N·m internal rotation torque. We tested the cadaveric specimens in 5 successive ligament situations: intact, ACL lesion, ACL + ALL lesion, ACL reconstruction, and ACL + ALL reconstruction. Anatomic single-bundle reconstruction methods were used for both the ACL and the ALL, with a bone-tendon quadriceps autograft and gracilis tendon autograft, respectively. Three-dimensional kinematics and articular surface interactions were used to determine knee laxity. Results: For the entire knee flexion motion, an ACL + ALL lesion increased the mean knee laxity ( P < .005) for internal rotation (2.54°), anterior translation (1.68 mm), and varus rotation (0.53°). Augmented ALL reconstruction reduced knee laxity for anterior translation ( P = .003) and varus rotation ( P = .047) compared with ACL + ALL–deficient knees. Knees with ACL + ALL lesions had more internal rotation ( P < .001) and anterior translation ( P < .045) at knee flexion angles below 40° and 30°, respectively, compared with healthy knees. Combined ACL + ALL reconstruction did not completely restore native kinematics/laxity at flexion angles below 10° for anterior translation and below 20° for internal rotation ( P < .035). ACL + ALL reconstruction was not found to overconstrain the knee joint. Conclusion: Augmented ALL reconstruction with ACL reconstruction in a cadaveric setting reduces internal rotation, varus rotation, and anterior translation knee laxity similar to knee kinematics with intact ligaments, except at knee flexion angles between 0° and 20°. Clinical Relevance: Patients with ACL injuries can potentially achieve better results with augmented ALL reconstruction along with ACL reconstruction than with stand-alone ACL reconstruction. Furthermore, dynamic radiostereometry provides the opportunity to examine clinical patients and compare the recontructed knee with the contralateral knee in 6 degrees of freedom.
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Varelas, Antonios N., Brandon J. Erickson, Gregory L. Cvetanovich e Bernard R. Bach. "Medial Collateral Ligament Reconstruction in Patients With Medial Knee Instability: A Systematic Review". Orthopaedic Journal of Sports Medicine 5, n. 5 (1 maggio 2017): 232596711770392. http://dx.doi.org/10.1177/2325967117703920.
Background: The medial collateral ligament (MCL) is the most frequently injured ligament of the knee, but it infrequently requires surgical treatment. Current literature on MCL reconstructions is sparse and offers mixed outcome measures. Purpose/Hypothesis: The purpose of this study was to compare the outcomes of isolated MCL reconstruction and multiligamentous MCL reconstruction. Our hypothesis was that in selective patients, MCL reconstruction would significantly improve objective and subjective patient knee performance measures, those being baseline valgus laxity, range of motion, objective and subjective International Knee Documentation Committee (IKDC) scores, Tegner score, and Lysholm knee activity scores. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and utilizing 3 computer-based databases. Studies reporting clinical outcomes of patients undergoing MCL reconstruction due to chronic instability or injury with mean follow-up of at least 2 years and levels of evidence 1 to 4 were eligible for inclusion. All relevant subject demographics and study data were statistically analyzed using 2-sample and 2-proportion z tests. Results: Ten studies involving 275 patients met our inclusion criteria. Of these patients, 46 underwent isolated MCL reconstruction while another 229 underwent reconstruction of the MCL in addition to a variety of concomitant reconstructions. Overall outcomes for all patients were significant for (1) reducing the medial opening of the knee (8.1 ± 1.3 vs 1.4 ± 1.0 mm; P < .001), (2) improving the patient’s objective IKDC score (1.2% vs 88.4%; P < .001), (3) improving the patient’s subjective IKDC score (49.8 ± 6.9 vs 82.4 ± 9.6; P < .001), and (4) improving the Lysholm knee activity score (69.3 ± 5.9 vs 90.5 ± 6.6; P < .001). No differences existed between concomitant reconstruction groupings except that postoperative Lysholm scores were better for MCL/anterior cruciate ligament reconstruction than MCL/posterior cruciate ligament reconstruction (94.3 ± 4.5 vs 84.0 ± 11.7; P < .001). Normal or nearly normal range of motion was obtained by 88% of all patients. Conclusion: The systematic review of 10 studies and 275 knees found that the reported patient outcomes after MCL reconstruction were significantly improved across all measures studied, with no significant difference in outcomes between concomitant reconstructions.
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Stannard, James P., Stephen L. Brown, Rory C. Farris, Gerald McGwin e David A. Volgas. "The Posterolateral Corner of the Knee". American Journal of Sports Medicine 33, n. 6 (giugno 2005): 881–88. http://dx.doi.org/10.1177/0363546504271208.
Background Injuries to the posterolateral corner of the knee are disabling. Despite improved understanding of this group of tendons and ligaments, the best surgical treatment of an unstable corner is not clear. Hypothesis Surgical repair of acute tears of the posterolateral corner has outcomes that are as good as those from reconstruction combined with an early motion rehabilitation protocol. Study Design Cohort study; Level of evidence, 2. Methods Sixty-three patients with 64 posterolateral corner tears were included in this study, with 39 posterolateral corner repairs and 25 reconstructions using the modified 2-tailed technique. Patients were evaluated with clinical and KT-2000 arthrometer examinations, as well as with Lysholm, International Knee Documentation Committee, and Short Form-36 scores. Results Fifty-six patients with 57 corner tears had minimum clinical follow-up of 24 months (range, 24-59 months). Acute primary repairs were performed on 35 patients, with 22 successful outcomes and 13 (37%) failures. Primary reconstructions were performed on 22 patients, with 20 successful outcomes and 2 (9%) failures. The difference in stability on clinical examination between repairs and reconstructions was significant (P <. 05). Fourteen of 15 patients with failures of the primary posterolateral corner repair or reconstruction underwent successful revision reconstruction. The final patient with failure of the primary repair elected not to have a revision reconstruction. The final mean Lysholm knee score for both repair and reconstruction patients was 88.7 (range, 53-100). Final International Knee Documentation Committee objective scores yielded 14 (26%) normal, 28 (52%) near-normal, 9 (17%) abnormal, and 3 (6%) severely abnormal knees; the mean score was 60 at the most recent clinical evaluation. Conclusion Results with repair followed by early motion rehabilitation have been significantly inferior when compared with results from reconstruction using the modified 2-tailed technique. The authors now use reconstruction rather than repair in the majority of patients who sustain posterolateral corner tears after high-energy injuries.
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Harner, Christopher D., Marsie A. Janaushek, Akihiro Kanamori, Masayoshi Yagi, Tracy M. Vogrin e Savio L.-Y. Woo. "Biomechanical Analysis of a Double-Bundle Posterior Cruciate Ligament Reconstruction". American Journal of Sports Medicine 28, n. 2 (marzo 2000): 144–51. http://dx.doi.org/10.1177/03635465000280020201.
The objective of this study was to experimentally evaluate a single-bundle versus a double-bundle posterior cruciate ligament reconstruction by comparing the resulting knee biomechanics with those of the intact knee. Ten human cadaveric knees were tested using a robotic/universal force-moment sensor testing system. The knees were subjected to a 134-N posterior tibial load at five flexion angles. Three knee conditions were tested: 1) intact knee, 2) single-bundle reconstruction, and 3) double-bundle reconstruction. Posterior tibial translation of the intact knee ranged from 4.9 2.7 mm at 90° to 7.2 1.5 mm at full extension. After the single-bundle reconstruction, posterior tibial translation increased to 7.3 3.9 mm and 9.2 2.8 mm at 90° and full extension, respectively, while the corresponding in situ forces in the graft were up to 44 19 N lower than those in the intact ligament. Conversely, with double-bundle reconstruction, the posterior tibial translation did not differ significantly from the intact knee at any flexion angle tested. This reconstruction also restored in situ forces more closely than did the single-bundle reconstruction. These data suggest that a double-bundle posterior cruciate ligament reconstruction can more closely restore the biomechanics of the intact knee than can the single-bundle reconstruction throughout the range of knee flexion.
Paton, Bruce Murray. "Knee swelling and anterior cruciate ligament reconstruction". Thesis, King's College London (University of London), 2017. https://kclpure.kcl.ac.uk/portal/en/theses/knee-swelling-and-anterior-cruciate-ligament-reconstruction(1dbd0b68-0e8b-42a9-bc5a-c6bf2cf22edd).html.
Swelling is universal after Anterior Cruciate Ligament Reconstruction (ACLR). Cooling compressive devices aim to treat swelling after surgery, but research has focussed more on pain than swelling. The aims of this work were to measure knee swelling in ACLR with a perometer (an optoelectric volumeter) and to evaluate an intervention for knee swelling in ACLR which uses a cold compressive device. The main outcome for the studies was knee volume measured using the perometer. Reliability was established and a randomised controlled trial was undertaken The study aimed to compare the use of Cryocuff, and elevation, with standard treatment used post ACLR (compression bandage alone). Secondary outcomes were also measured to assess the correlates of knee swelling in ACLR. The patients were randomised into a standard treatment group or into a Cryocuff and elevation group. Knee volume in both knees was measured pre-operatively and at two weeks post-operatively using the perometer. Secondary variables measured included: - range of movement, pain, knee laxity and function, medication use, tourniquet and discharge times, and operative factors. There was with no significant difference between the groups (p=0.977). This study did not find Cryocuff and elevation to be more effective for minimising swelling at 2 weeks post-operatively, than a compression bandage alone. The perometer was reliable with Intra class correlation coefficient of 0.996. Significant correlates of swelling post-ACLR were: blood pressure; knee joint laxity and extension loss, with daily elevation time and Intravenous fluid given intra operatively close to significance. Further investigation outlined the level and profile of compression applied to the knee by the Cryocuff found that this device may have inherent features that could be provocative of swelling.
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Wasielewski, Noah Jon. "Predictors of functional outcome following anterior cruciate ligament reconstruction /". view abstract or download file of text, 2002. http://wwwlib.umi.com/cr/uoregon/fullcit?p3061971.
Thesis (Ph. D.)--University of Oregon, 2002. Typescript. Includes vita and abstract. Includes bibliographical references (leaves 212-238). Also available for download via the World Wide Web; free to University of Oregon users.
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Nesbitt, Rebecca J. "Establishing Design Criteria for Anterior Cruciate Ligament Reconstruction". University of Cincinnati / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1428048607.
Jayashekar, Sundareswar. "Three dimensional image reconstruction of skeletal tissue from computed tomography". Morgantown, W. Va. : [West Virginia University Libraries], 2000. http://etd.wvu.edu/templates/showETD.cfm?recnum=1745.
Thesis (M.S.)--West Virginia University, 2000. Title from document title page. Document formatted into pages; contains vii, 57 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 50-51).
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An, Vincent Vinh Gia. "Predictive models in knee surgery". Thesis, The University of Sydney, 2018. http://hdl.handle.net/2123/20063.
Reconstructive knee surgery is the definitive option for patients with knee pathology which causes irreconcilable functional deficit, or which is otherwise unacceptable without direct intervention. There are many factors which affect patient outcomes post-operatively, whether they are patient-specific factors, or intraoperative decision making. This thesis aimed to frame and generate predictive models which could guide clinical and intraoperative decision making with regards to two reconstructive procedures in knee surgery: total knee arthroplasty (TKA) and anterior cruciate ligament reconstruction (ACLR).
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Stanley, Christopher J. Yu Bing. "Effects of knee extension constraint on knee flexion angle and ground reaction forces after ACL reconstruction". Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2006. http://dc.lib.unc.edu/u?/etd,532.
Thesis (M.S.)--University of North Carolina at Chapel Hill, 2006. Title from electronic title page (viewed Oct. 10, 2007). "... in partial fulfillment of the requirements for the degree of Master of Science in the Department of Human Movement Science." Discipline: Human Movement Science; Department/School: Medicine.
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Sambatakakis, A. "Biomechanics of imbalance in the reconstruction of the arthritic knee". Thesis, University of Strathclyde, 1993. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.312145.
Beard, David John. "Hamstring contraction latency following anterior cruciate ligament rupture, reconstruction and rehabilitation". Thesis, University of Oxford, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.308448.
Smale, Kenneth. "Relating Subjective and Objective Knee Function After Anterior Cruciate Ligament Injury Through Biomechanical and Neuromusculoskeletal Modelling Approaches". Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/37947.
Background: Knee injuries have a considerable impact on both the person’s psychological and physical health. We currently have tools to address each of these aspects but they are often considered independent of each other. Little work has been done to consolidate the subjective and objective functional ability of anterior cruciate ligament (ACL) injured individuals, which can be detrimental when implementing a return-to-play decision-making scheme. The lack of understanding concerning the relationship of these two measures may account for the high incidence of re-injury rates and lower quality of life exhibited by so many of these patients.
Purpose: The purpose of this doctoral thesis is to investigate the relationship between subjective and objective measures of functional ability in ACL deficient and ACL reconstructed conditions through biomechanical and neuromusculoskeletal modelling approaches.
Methods: This thesis is comprised of five studies based on a single in vivo data collection protocol, medical imaging and in silico data analyses. The in vivo data collection was of test-retest design where ACL deficient patients participated prior to their operation and approximately ten months post-reconstruction. This experimental group was matched to a healthy, uninjured control group, which was tested a single time.
The first study of this thesis involved a descriptive analysis of spatiotemporal, neuromuscular, and biomechanical patterns during hopping and side cut tasks in addition to subjective functional ability questionnaires. Then, two novel measures of dynamic knee joint control were developed and applied along with a third measure to determine if changes in joint control exist between the three groups (Study 2). The relationships of these objective measures of functional ability to subjective measures were then examined through correlation and regression models (Study 3). Following this, a method of including magnetic resonance imaging to construct patient-specific models was developed and implemented to determine realistic kinematic and ligament lengthening profiles (Study 4). These patient-specific models were then applied to quantify knee joint loading in the form of contact and ligament forces, which were correlated to subjective measures of functional ability (Study 5).
Results: Even though no major differences in neuromuscular patterns were observed between all three groups, it was found that subjective patient-reported outcome measures scores and biomechanical measures in the form of knee flexion angles and extensor moments were lower in the ACL deficient group compared to healthy controls. These differences continued to exist 10 months post-operation as the ACL reconstructed group had not fully recovered to patterns observed in the healthy controls. The current findings also suggest a possible hierarchy in the relationships between objective and subjective measures of functional ability. Basic kinematic objective measures such as knee flexion angle show small to moderate correlations, while more comprehensive measures such as stiffness and joint compressive force show moderate to strong correlations to subjective questionnaires. Finally, this thesis developed patient-specific OpenSim models that were used to produce appropriate kinematics and ligament lengthening with the reduction in soft tissue artefact.
Conclusion:
This thesis demonstrated that patients who are high-functioning in the ACL deficient state show greater improvements in subjective outcome scores after ACL reconstruction compared to objective measures. Biomechanical and neuromusculoskeletal modelling approaches identified important differences between the healthy and ACL deficient groups that were not resolved post-operatively. Our results also demonstrate that certain subjective and objective measures of functional ability are strongly correlated. The knowledge gained from this test-retest design and novel patient-specific in silico models aids clinicians in managing their expectations regarding the effectiveness of reconstruction and the respective long-term sequelae.
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Mikkelsen, Christina. "Rehabilitation following bone-patellar tendon-bone graft ACL reconstruction /". Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-913-0/.
Confalonieri, Norberto, e Sergio Romagnoli, a cura di. Small Implants in Knee Reconstruction. Milano: Springer Milan, 2013. http://dx.doi.org/10.1007/978-88-470-2655-1.
Glassman, Andrew H., Paul F. Lachiewicz e Tanzer Michael. Orthopaedic knowledge update: Hip and knee reconstruction 4. A cura di American Academy of Orthopaedic Surgeons, Hip Society (U.S.) e Knee Society (U.S.). 4a ed. Rosemont, IL: American Academy of Orthopaedic Surgeons, 2011.
Burns, Robert, Natalie L. Zusman, Michael B. Cross, Alexander S. McLawhorn, Rachel M. Frank, Bryan D. Haughom, Peter K. Sculco et al. "Knee Reconstruction". In Passport for the Orthopedic Boards and FRCS Examination, 777–833. Paris: Springer Paris, 2015. http://dx.doi.org/10.1007/978-2-8178-0475-0_37.
Longino, D., N. Clerk, P. J. Fowler e J. R. Giffin. "Technique in ACL reconstruction: Hamstring reconstruction". In The Knee Joint, 195–202. Paris: Springer Paris, 2012. http://dx.doi.org/10.1007/978-2-287-99353-4_17.
Baren, James P., Emma Rowbotham, Scott D. Wuertzer e Andrew J. Grainger. "Knee: Ligament Reconstruction". In Postoperative Imaging of Sports Injuries, 151–99. Cham: Springer International Publishing, 2020. http://dx.doi.org/10.1007/978-3-030-54591-8_6.
Kihara, Shinsuke, Sean J. Meredith, Benjamin B. Rothrauff e Freddie H. Fu. "Evolution of ACL Reconstruction". In Knee Arthroscopy, 41–55. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-8191-5_4.
Harris, Joshua D., e Brian J. Cole. "Fresh Osteochondral Allograft". In Biologic Knee Reconstruction, 125–32. Boca Raton: CRC Press, 2024. http://dx.doi.org/10.1201/9781003522768-22.
Frank, Jonathan M., e Bernard R. Bach. "Chondral and Osteochondral Defect Classification". In Biologic Knee Reconstruction, 47–50. Boca Raton: CRC Press, 2024. http://dx.doi.org/10.1201/9781003522768-8.
Ellman, Michael B., e Charles A. Bush-Joseph. "Patient Evaluation". In Biologic Knee Reconstruction, 19–24. Boca Raton: CRC Press, 2024. http://dx.doi.org/10.1201/9781003522768-4.
Bloemker, Katherine H., e Trent M. Guess. "Effects of ACL Reconstruction Techniques on the Kinematics of the Knee in a Computational Knee Model". In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53276.
This study examines the effects of different Anterior Cruciate Ligament (ACL) reconstruction techniques on computational multibody knee models. The knee models were derived from two cadaver knees that underwent simulated walk cycles while the kinematics of the knee geometries were collected in a dynamic knee simulator. Once the computational models performed well compared to experimental data, multiple simulated ACL reconstruction surgeries were done on each model. For each simulated reconstruction technique, overall knee kinematics was compared to the experimental cadaver results and anterior-posterior movement of the tibia relative to the femur was compared to the original, intact computational model. The factors examined were ACL reconstruction method, adding preload to the reconstruction element, and reconstruction element type.
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Sakane, M., G. Li, R. J. Fox, S. L. Y. Woo, T. W. Rudy, G. Livesay e F. H. Fu. "The Advantage of Robot-Assisted Knee Positioning for ACL Reconstruction Surgery". In ASME 1996 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1996. http://dx.doi.org/10.1115/imece1996-1282.
Abstract The goal of ACL reconstruction surgery is to restore normal ligament function and knee kinematics. Multiple factors can contribute to its outcome. Studies using cadaveric knees have been conducted to examine the effect of surgical variables on ACL reconstruction (1–3,7). However, large inter-specimen variability, less-than-reproducible surgical techniques, difficulties in data collection, and so on have made it difficult to determine the effect of these surgical variables independently. In this study, we studied the effect of knee positioning during ACL reconstruction on in-situ graft force and anterior tibia displacement of the knee when subjected to anterior tibial load. We hypothesize that a robot-assisted positioning of a knee to its initial/intact state should result in better outcomes (5) when compared with the conventional (empirical) positioning by a surgeon.
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Jeung, Deokgi, Hyun-Joo Lee, Hee-June Kim e Jaesung Hong. "Augmented Reality-based Surgical Guidance for Anterior and Posterior Cruciate Ligament Reconstruction". In THE HAMLYN SYMPOSIUM ON MEDICAL ROBOTICS. The Hamlyn Centre, Imperial College London London, UK, 2023. http://dx.doi.org/10.31256/hsmr2023.26.
Anterior and posterior cruciate ligament (ACL and PCL) reconstructions are common knee arthroscopic surgeries. ACL and PCL reconstruction have small incision sites, thus enabling fast recovery of the patient. However, an arthroscope provides a limited view due to the small size of the camera lens, and a small incision restricts the motion of surgical instruments. As a result, finding the exact bone drilling position that was preoperatively determined to connect a new ligament between the femur and tibia is challenging during surgery. A previous study verified that the complication ratio of ACL and PCL reconstruction is 9.0 % and 20.1 %, respectively, which are particularly high compared to other knee arthroscopic surgeries [1]. Augmented reality (AR)-based surgical guidance can assist in difficult ACL and PCL reconstruction. Hu et al. [2] proposed AR-based non-invasive drilling guidance for the femur in open knee surgery. To implement the non-invasive system, they performed the registration between the depth data of the femur obtained from RGBD sensors and the pre-scanned femur model. However, this method is suitable for open knee surgery and is not for arthroscopic surgeries such as ACL and PCL reconstruction. Recently, Chen et al. [3] introduced non-invasive AR for knee arthroscopy. However, to reflect knee movements occurring during surgery in AR, it is necessary to manually select four anatomical landmarks in the arthroscopic view. Manual selection is inconvenient and may be inconsistent, interfering with surgical procedures. In this study, we propose a non-invasive AR-based surgical guidance for ACL and PCL reconstruction with compensation of the intraoperative knee movement. Unlike preoperative CT and MR, which are taken under the extension state, the knee is under the flexion state during surgery, which requires compensation for the knee movement. The proposed method estimates knee movement without direct bone exposure or manual intervention by exploring the correlation between the knee surface and the internal bones (femur and tibia) based on a finite element method. The proposed method can enhance the AR for knee arthroscopic procedures, leading to more accurate bone drilling for ACL or PCL reconstruction.
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Sardarescu, M., N. Paragios, N. Komodakis, R. Raymond, P. Hernigou e A. Rahmouni. "Knee reconstruction through efficient linear programming". In 2008 IEEE International Symposium on Biomedical Imaging: From Macro to Nano (ISBI '08). IEEE, 2008. http://dx.doi.org/10.1109/isbi.2008.4541083.
Quigley, Ryan J., Hideya Ishigooka, Michelle H. McGarry, Yu J. Chen, Akash Gupta, Chris Bui e Thay Q. Lee. "Anatomical Posterolateral Corner Reconstruction of the Knee Using a New Fibula Cross Tunnel Method: A Cadaveric Study". In ASME 2010 5th Frontiers in Biomedical Devices Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/biomed2010-32041.
Posterolateral corner (PLC) injury of the knee causes varus and posterolateral rotatory instability. The anatomy of the PLC has been reported in the literature but the importance of PLC reconstruction has only recently been established and ideal reconstruction techniques are still in development. The native function of the PLC is to restrain varus and external rotation. Reconstruction methods should properly restore these functions without overconstraining the joint. Several reconstructions for PLC injury have been reported but with concerns of iatrogenic neurovascular injury, fibular head cutout, and restoration of the knee kinematics. To address these concerns, a new cross fibula tunnel method was developed that may have lower risk of iatrogenic nerve injury and fibula head cutout. The purpose of this study was to verify the stability of this technique using a PLC deficient knee.
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Caruntu, Dumitru I. "3-D Knee Biomechanics". In ASME 2008 International Mechanical Engineering Congress and Exposition. ASMEDC, 2008. http://dx.doi.org/10.1115/imece2008-67633.
This is a survey on 3-D dynamic and quasi-static human knee joint modeling. Anatomical surface representation, contact modeling, ligament structure, and solution algorithm are reviewed. Understanding knee joint biomechanics is important for total knee replacement and rehabilitation exercise design, ligament reconstruction, and cartilage damage. Knee models were proposed mostly in the last two decades. They aimed normal activities and rehabilitation exercises, and sought muscle, ligament, and joint contact forces. Consisting of two joints, tibio-femoral (TF) and patello-femoral (PF), the human knee 3-D models were PF, TF [1–3], and both TF and PF [4–7]. Models were static, quasi-static, and dynamic, including the entire, partial, or none of the ligament structure. Contact models of the knee were rigid or deformable. Both natural knees and replacement models were reported. Different groups of muscles were considered.
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Limpisvasti, Orr. "Arthroscopy and Ligament Reconstruction in the Knee". In ASME 2009 4th Frontiers in Biomedical Devices Conference. ASMEDC, 2009. http://dx.doi.org/10.1115/biomed2009-83081.
Ligament injuries in the knee are a common cause of disability in the active population. The advent of arthroscopy and arthroscopic surgical techniques has changed our ability to diagnose and treat these injuries. Arthroscopy has become the gold standard for diagnosis of intra-articular ligament injuries, as well as meniscal and articular cartilage pathology. It combines optimal visualization and the ability to manipulate tissue under anesthesia to best understand the degree of ligament injury and knee instability. Arthroscopy has also evolved into the primary means for the surgical treatment of injuries to intra-articular ligaments, articular cartilage, and meniscus.
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Edd, Shannon N., Nathan A. Netravali, Julien Favre, Nicholas J. Giori e Thomas P. Andriacchi. "Meniscectomized Knees Regain Normal Walking Flexion Range of Motion With Time Past Surgery". In ASME 2013 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2013. http://dx.doi.org/10.1115/sbc2013-14746.
Meniscal tears are one of the most common knee injuries with an incidence rate of 60–70 per 100,000 person-years [1]. Although arthroscopic partial meniscectomy, the leading treatment for meniscal tears, decreases pain, the risk of knee osteoarthritis (OA) is four times higher for a meniscectomized knee compared to an uninjured knee [2]. Prior research has shown that meniscectomized knees have reduced sagittal-plane range of motion in the early period following surgery (6 to 18 months) [3–5]. These observations suggest a mechanical pathway to knee OA, in which alteration in ambulatory knee function causes shifts in tibiofemoral cartilage location to unprepared cartilage regions, thus causing damage to the maladapted tissue [6]. While such a mechanical pathway is well documented for knees with reconstruction of the anterior cruciate ligament [7], the paucity of information regarding the walking mechanics of meniscectomized knees at longer term post-operation limits our understanding of the pathway to OA in this population. Particularly, it is unknown whether meniscectomized knees regain normal dynamic range of motion (ROM) in knee flexion with time past surgery. Because regaining ROM alters the mechanical function in the meniscectomized knee, understanding the changes in this gait variable over time may help elucidate the various pathways to OA development in meniscectomized knees.
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Papaioannou, George, William Anderst e Scott Tashman. "Elevated Joint Contact Forces in ACL-Reconstructed Knees: A Finite Element Analysis Driven by In Vivo Kinematic Data". In ASME 2003 International Mechanical Engineering Congress and Exposition. ASMEDC, 2003. http://dx.doi.org/10.1115/imece2003-43067.
Assessment of in vivo human cartilage loading generally requires computer modeling, since loads usually cannot be directly measured. The utility of these models for assessing knee behavior during complex activities has been limited by the relatively poor quality of experimental data on in vivo knee function. We have developed a method combining high-accuracy knee kinematics (from high-speed stereo-radiography) with subject-specific finite-element models to estimate in vivo cartilage contact pressures during stressful tasks. When applied to ACL reconstruction, significantly higher contact pressures were found in reconstructed knees as compared to the contralateral (uninjured) knees of the same individuals.
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Boguszewski, Daniel V., Jason T. Shearn, Christopher T. Wagner e David L. Butler. "Effect of ACL Reconstruction Graft Material on Joint Force Loss During Cyclic Fatigue Testing Using a 6-DOF Motion". In ASME 2010 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2010. http://dx.doi.org/10.1115/sbc2010-19294.
As many as 250,000 people suffer anterior cruciate ligament (ACL) injury annually [1]. As the primary ligamentous restraint to anterior tibial translation [2–3], the ACL is surgically reconstructed in an attempt to restore knee stability. However, up to 10–25% of reconstructions still fail [4]. While reconstructions restore antero-posterior kinematics, abnormal kinematics persist in other directions [5], leading to a shift in cartilage contact and poor adaptation to altered load [5]. With or without reconstruction, the likely prognosis after ACL injury is long-term osteoarthritis [6]. Improving this outcome requires assessment of the limitations of ACL graft reconstruction compared to normal ACL forces during simulated activities of daily living (ADLs). Our objective in this study was to evaluate the magnitude and temporal changes in force for the intact versus ACL-reconstructed knee over 2000 cycles of a simulated ADL.
Rapporti di organizzazioni sul tema "Knee Reconstruction":
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Ma, Chao, Yiran Deng e Xianliang Wang. Effect of professional sports rehabilitation on functional recovery of the knee joint after anterior cruciate ligament reconstruction：A Meta-Analysis of Randomized Controlled Trials. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, febbraio 2023. http://dx.doi.org/10.37766/inplasy2023.2.0054.
