Medial Patellofemoral Ligament Reconstruction Using the Anterior Half of the Peroneus Longus Tendon Graft.

Background: Medial patellofemoral ligament (MPFL) reconstruction is the main procedure performed for recurrent patellar instability. Choosing wisely between graft options is particularly important in this specific population, who often lacks neuromuscular control. The gracilis, semitendinosus, and quadriceps tendons are the most frequently used autografts, but harvesting can lead to reduced thigh muscle strength and poorer balance control.

Quantifying anterior tibial translation and rotation in chronic ACL-deficient knees: a prospective, observational study using weight-bearing CT.

Objective: To evaluate the ability of weight-bearing computed tomography (WBCT) to detect and quantify differences in anterior tibial translation (ATT) and tibiofemoral rotation (TFR) between anterior cruciate ligament (ACL)-injured and uninjured knees in patients with chronic ACL tears.

Materials And Methods: This prospective, observational study included 20 patients (40 knees) with chronic unilateral ACL injuries confirmed by clinical exam and MRI. Knee WBCT was performed in four standardized positions: full extension and 30° flexion (bipodal), and internal and external rotation (unipodal).

Combined ACL and Anterolateral Ligament Reconstruction Using an Adjustable-Loop Fixation Device: Surgical Technique.

Background: There are several techniques for the combined reconstruction of the anterior cruciate ligament (ACL) and the anterolateral ligament (ALL), but none have shown superiority. This study aims to present a surgical technique that theoretically reduces some of the risks reported in these procedures.

Indications: The main indications for the ALL reconstruction include chronic ACL injuries, revision ACL reconstruction, acute ACL injuries in patients with high-grade pivot-shift (grades 2 or 3), patients involved in pivoting sports, and generalized ligament hyperlaxity or knee hyperextension.

Editorial Commentary: Lateral Extra-articular Augmentations in Anterior Cruciate Ligament (ACL) Reconstruction Reduce ACL Graft Failure and Secondary Meniscectomy and Are Indicated for ACL Primary and Revision Reconstruction.

In the past decade, increasing evidence supports knee lateral extra-articular tenodesis or anterolateral ligament reconstruction for anterolateral rotational instability in patients requiring anterior cruciate ligament (ACL) reconstruction. Extra-articular augmentation reduces the risk of ACL graft failure, particularly in high-risk populations. Recent research shows a 3-fold lower risk of failure and a lower rate of secondary meniscectomy.

Predicting ACL Reconstruction Failure with Machine Learning: Development of Machine Learning Prediction Models.

Background: Anterior cruciate ligament reconstruction (ACLR) is the predominant and widely accepted treatment modality for ACL injury. However, recurrence of ACL rupture or failure of the reconstruction remains a significant challenge. Despite several studies in the literature that have developed prediction models to address this issue by identifying prognostic factors for treatment outcomes using classical statistical methods, the predictive efficacy of these models is frequently suboptimal.

Increased internal tibiofemoral rotation is associated with anterolateral ligament injury and high-grade pivot-shift in ACL-injured patients.

Purpose: To evaluate whether tibiofemoral rotation is associated with a concurrent anterolateral ligament (ALL) injury and pivot-shift grading in patients with a primary anterior cruciate ligament (ACL) tear.

Methods: In this multicenter cross-sectional study constituting a secondary analysis of previous studies, medical records and magnetic resonance imaging (MRI) scans of patients with unilateral primary ACL injury were reviewed. Demographics and pivot-shift grading were collected.

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using a Flexible Reaming System.

The combination of anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction represents a therapeutic modality that exhibits superior clinical efficacy for certain risk groups when compared with isolated ACL reconstruction. This approach is progressively gaining broader applicability owing to its inherent prospective advantages. Despite the absence of a universally acknowledged gold-standard surgical technique, several methods have been delineated for its implementation.

Clinical outcomes of repaired radial meniscal tears: A retrospective study with minimum 2-year follow-up.

Background: The management of meniscal radial tears has changed significantly in recent years in favor of meniscus repair. However, there is still limited published data on the outcomes and risk factors associated with repair failure. The objective of this study is to evaluate the clinical success rate of repaired meniscal radial tears and identify potential risk factors for failure.

An isolated extra-articular procedure can be indicated for patients with minor instabilities and intact graft after anterior cruciate ligament reconstruction.

Background: Some patients submitted to isolated ACL reconstruction may have symptomatic postoperative rotational instability. The objective of this study was to evaluate a population with mild rotatory instability after ACL reconstruction, which was submitted to an isolated extra-articular procedure.

Methods: Patients submitted to an isolated extra-articular procedure after ACL reconstruction were retrospectively evaluated.

Inframalleolar harvest of the peroneus longus tendon graft: Surgical technique.

Peroneus longus tendon (PLT) graft has recently gained visibility in the literature as a promising option for knee ligament reconstructions. The most used harvesting technique is performed with a single incision posterior to the lateral malleolus, with large series reporting tendon lengths enough to prepare a double or triple anterior cruciate ligament (ACL) graft, resulting in mean diameters greater than 8.0 mm.

Patients submitted to re-revision ACL reconstruction present more knee laxity, more complications, and a higher failure rate than patients submitted to the first revision ACL reconstruction.

Background: Few comparative studies have evaluated patients who underwent two revision anterior cruciate ligament reconstruction (ACLR) and patients who underwent one revision ACLR, and many of them have a short postoperative follow-up and a relatively small number of patients. The objective of this study is to evaluate the functional results, complications, and failure rates of patients who underwent one revision ACLR and patients who underwent two revision ACLRs.

Methods: This is a retrospective study comparing patients who underwent one revision ACLR (Group 1) with patients who underwent a re-revision ACLR (Group 2).

Microfragmented Adipose Tissue Associated With Collagen Membrane in the Treatment of Focal Knee Cartilage Defect.

Focal articular cartilage defects are an important factor that leads to dysfunction of the knee joint. Several different surgical approaches have been tried, most of them showing poor results in the long term. The use of orthobiologics in the context of focal chondral lesion has emerged as a potential tool in the treatment of this condition.

Demographic characteristics and clinical-radiological correlation in patients with indications for Total Knee Arthroplasty: A cross-sectional study.

Objective: The objective of this study is to correlate clinical symptoms and functionality, using the KOOS (Knee Injury and Osteoarthritis Outcome Score) and KSS (Knee Society Score System) scores, with the radiographic changes, using the Kellgren-Lawrence classification, in patients with knee osteoarthritis and indications for Total Knee Arthroplasty (TKA).

Methods: 120 patients (189 knees) with gonarthrosis and indications for TKA were included in the study. Demographic questionnaires were applied, and clinical and functional assessment was carried out using the KOOS and KSS scores.

Recovery of Full Hyperextension After Anterior Cruciate Ligament Reconstruction Is Associated With Better Functional Outcomes but Greater Anterior Cruciate Ligament-Related Laxity After a Minimum 24-Month Follow-Up.

Purpose: To evaluate patients who had anterior cruciate ligament (ACL) reconstruction with preoperative hyperextension and compare physical examination (KT-1000 and pivot shift) and patient-reported outcome measures of patients who recovered the entire hyperextension with patients who did not.

Methods: Patients aged 18 to 60 years with more than 5° of knee hyperextension who had anatomic ACL reconstruction with any graft from June 2013 to June 2021 and at least a 24-month follow-up were evaluated retrospectively. Hamstrings and patellar tendon grafts were fixed around 20° to 30° of flexion and in full extension, respectively.

Medial Patellofemoral Ligament Reconstruction Using the Medial Third of the Patellar Tendon: Camanho's Technique.

The reconstruction of the medial patellofemoral ligament (MPFL) is an essential procedure in the surgical treatment of patellar instability. The medial third of the patellar tendon is a good graft option for this reconstruction, maintaining the insertion of the graft in the patella, with no need for hardware for patellar fixation. The objective of this article is to describe the MPFL reconstruction technique with the patellar tendon graft.

Combined Anterior Cruciate Ligament and Anterolateral Ligament Reconstruction Using a Single Peroneus Longus Tendon Graft.

The peroneus longus tendon seems a viable graft option for knee ligament reconstructions, with adequate biomechanical properties and low morbidity after harvesting. The objective of this article is to describe a combined anterior cruciate ligament and anterolateral ligament reconstruction technique using a single peroneus longus tendon graft harvested from the infra malleolar region to ensure sufficient length.

Assessment of knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT): a novel protocol and preliminary results.

Objective: To propose a protocol for assessing knee instability in ACL-injured knees using weight-bearing computed tomography (WBCT).

Materials And Methods: We enrolled five patients with unilateral chronic ACL tears referred for WBCT. Bilateral images were obtained in four positions: bilateral knee extension, bilateral knee flexion, single-leg stance with knee flexion and external rotation, and single-leg stance with knee flexion and internal rotation.

Reconstruction of the Posterior Cruciate Ligament and Medial Collateral Ligament With a Single Combined Femoral Tunnel.

Background: Lesions of the medial collateral ligament (MCL) are the most common knee ligament injuries and, when they occur in isolation, they often progress with satisfactory outcomes using conservative treatment. However, MCL lesions associated with anterior cruciate ligament or posterior cruciate ligament (PCL) injuries in knee dislocations should be reconstructed to prevent failure of the central pivot. In knees with combined injuries involving the PCL and the MCL, the confluence of tunnels in the medial femoral condyle can be a potential problem during reconstruction surgery.

Reconstruction of the Anterior Cruciate Ligament and the Posterolateral Corner With a Single Combined Femoral Tunnel.

Background: Posterolateral knee injuries can occur in 16% of patients with acute ligament injuries, and up to 70% have a combined anterior cruciate ligament (ACL) tear. Studies have shown that, in different populations, the distance between the insertion of the popliteus tendon and the lateral collateral ligament (LCL) may be smaller than the 18.5 mm previously reported in the literature.

Risk Factors for Symptomatic Cyclops Lesion Formation after Anterior Cruciate Ligament Reconstruction.

 To evaluate the incidence of symptomatic cyclops lesions requiring surgical treatment after anterior cruciate ligament (ACL) reconstruction and to establish possible intraoperative risk factors related to it.  Three hundred and eighty-nine patients aged between 18 and 50 years who underwent primary ACL reconstruction were retrospectively evaluated. Patients were divided into groups according to the presence or absence of symptomatic cyclops lesions, and their characteristics were compared.

Comparison Between Continuous and Separate Grafts for ALL Reconstruction When Combined With ACL Reconstruction: A Retrospective Cohort Study From the SANTI Study Group.

Background: While various techniques have been described to augment the anterolateral side of the knee, such as lateral extra-articular tenodesis and anterolateral ligament (ALL) reconstruction (ALLR), it is unclear how they affect clinical outcomes. The aim of this study was to compare the results of 2 ALLR techniques for combined anterior cruciate ligament (ACL)/ALL reconstruction.

Hypothesis: The graft rupture rate, complications, and patient-reported outcomes are similar between a reconstruction technique using a continuous gracilis graft (CG) and single femoral tunnel for ACL/ALL reconstruction, and one using a separate gracilis graft (SG) and independent femoral tunnels.

Patients With More Than 6.5° of Knee Hyperextension are 14.6 Times More Likely to Have Anterior Cruciate Ligament Hamstring Graft Rupture and Worse Knee Stability and Functional Outcomes.

Purpose: To create a cut-off point for hyperextension that best discriminates retear and to verify whether this cut-off point can predict retear regardless of other characteristics after primary anterior cruciate ligament (ACL) reconstruction with hamstrings autograft.

Methods: A cohort of patients submitted to primary isolated ACL reconstruction with hamstrings autografts was retrospectively evaluated. Patients were stratified according to the degree of passive knee hyperextension measured in the normal contralateral knee.