The majority of elite and professional athletes return to the preinjury level of activity after ACL reconstruction: A systematic review and meta-analysis.

Purpose: To compare return to play (RTP), time to RTP, level of RTP, and anterior cruciate ligament (ACL) graft failure among elite and professional athletes from different sports after anterior cruciate ligament reconstruction (ACLR).

Methods: The PubMed, Embase and Cochrane Library databases were searched to identify potentially relevant research articles that analysed RTP, time to RTP, level of RTP, and graft failure rate in elite and professional athletes after ACLR. An elite or professional athlete was defined as one who participates in national- or international-level competitions in professional or amateur sports-including academy players aged 15 years or over.

The meniscofemoral ligaments do not contribute to restriction of posterior tibial translation: A robotic biomechanical analysis.

Purpose: The aim of this study was to quantify the contribution of the meniscofemoral ligaments (MFLs) on restraining a posterior tibial translation (PTT) in the human knee joint.

Methods: Sixteen human cadaveric knee joints were tested in a robotic test setup with six degrees of freedom. Knees with no MFL, one MFL and two MFLs were included.

Location of lateral tibial plateau fractures relative to the posterolateral complex predicts the need for extension of lateral approaches: A retrospective observational study.

Purpose: Extended lateral approaches have been proposed to improve visualization and therefore reduction quality of the articular surface in lateral tibial plateau fractures. However, recommendations regarding the exact morphology of lateral tibial fractures requiring extended approaches are lacking.

Methods: A retrospective observational cohort study was conducted using data from patients who underwent surgical treatment of a tibial plateau fracture involving the lateral tibial plateau (AO/OTA 41-B3 and 41-C3) at a level 1 trauma center between January 2020 and May 2024.

Indications for Lateral Extra-articular Procedures in the Anterior Cruciate Ligament-Reconstructed Knee: Part I of an International Consensus Statement.

Purpose: To define expert consensus on whether and how lateral extra-articular procedures (LEAPs) should accompany anterior cruciate ligament (ACL) reconstruction to optimize outcomes in ACL-deficient knees.

Methods: Fifty-five knee surgeons from 17 countries on 5 continents completed a 3-round modified Delphi process. Twenty-one statements on patient selection for combined ACL reconstruction (ACLR) + LEAPs were graded on 5-point Likert scales; ≥75% "agree/strongly agree" signified consensus.

A novel meniscal root refixation pull-in technique with an all-suture anchor shows biomechanical properties comparable to standard suture anchor and transtibial pull-out techniques.

Purpose: Repair techniques for posterior meniscal root (PMMR) tears include repair with transtibial pull-out and anchors. An alternative approach uses all-suture anchors pulled in, avoiding a posterior medial portal. While clinical feasibility has been assessed, biomechanical properties of this technique remain unknown.

Tibial tuberosity-trochlea groove distance is dependent on flexion angle and intra-articular version in different magnetic resonance imaging recording techniques.

Purpose: The purpose of this study was to compare the tibial tuberosity-trochlea groove distance (TT-TG) and the tibial tuberosity-posterior cruciate distance (TT-PCL) between conventional and rotatory magnetic resonance imaging (MRI). It was hypothesised that the TT-TG varies between the investigated techniques, due to differences in knee flexion angle and intra-articular version. Variations in TT-TG could lead to misdiagnoses and consequently result in inappropriate surgical indications.

Several flat tendon graft types are viable options for flat superficial medial collateral ligament reconstructions-A biomechanical analysis.

Purpose: Flat superficial medial collateral ligament (sMCL) reconstruction helps restore knee kinematics in medial instability, but recommendations on grafts that best mimic the sMCL's biomechanical properties are missing. This study aimed to compare the biomechanical properties of flat grafts to the native sMCL, hypothesizing that (1) flat grafts exhibit unique biomechanical properties and (2) graft configuration affects their biomechanical properties.

Study Design: Controlled laboratory study.

Plate-augmented fixation of comminuted Letenneur type II Hoffa fractures provides favorable stability compared to isolated posteroanterior screw fixation - a biomechanical study.

Introduction: Current literature lacks recommendations regarding proper fixation of comminuted coronal plane fractures of the posterior femoral condyles (Hoffa fractures). Therefore, the aim of this study was to compare the biomechanical characteristics of different plate-augmented constructs to isolated posteroanterior screw fixation in comminuted lateral Hoffa fractures.

Materials And Methods: Comminuted Letenneur type IIb lateral Hoffa fractures were simulated in 24 human cadaveric distal femora.

The Type of Lateral Hinge Fracture in Medial Open-Wedge High Tibial Osteotomy Determines Its Stability: A Biomechanical Study.

Background: Lateral hinge fractures (LHFs) are considered risk factors for delayed union or nonunion after medial open-wedge high tibial osteotomies (MOWHTOs). However, there is limited evidence on the extent to which the morphology of the hinge fracture influences the stability of a MOWHTO.

Purpose/hypothesis: The purpose of this study was to validate the Takeuchi classification under axial and torsional loading to identify the LHF types requiring surgical treatment.

A practical guide to the implementation of AI in orthopaedic research-Part 7: Risks, limitations, safety and verification of medical AI systems.

Unlabelled: Artificial intelligence (AI) has been influencing healthcare and medical research for several years and will likely become indispensable in the near future. AI is intended to support healthcare professionals to make the healthcare system more efficient and ultimately improve patient outcomes. Despite the numerous benefits of AI systems, significant concerns remain.

Impact of screw design on refixation of solid avulsion fractures of the posterior cruciate ligament-A biomechanical feasibility study.

Purpose: Avulsion fractures of the posterior cruciate ligament (PCL) are commonly treated with refixation. Headless compression screws (HCS) offer benefits, compared to conventional techniques, such as reduced material irritation and option of bioabsorbable materials, possibly avoiding implant removal. Proofing its clinical applicability, the authors hypothesized that (1) biomechanical properties of HCS would be comparable to conventional techniques and (2) magnesium-based HCS would provide comparable properties to titanium HCS.

Combined apophyseal and epiphyseal fixation of Ogden type IIIA/IV tibial tubercle avulsion fractures provides favorable stability compared to isolated apophyseal screw fixation - a biomechanical study.

Purpose: Current literature lacks recommendations regarding proper fixation of tibial tubercle avulsion fractures involving the proximal tibial epiphysis (Ogden fractures). Therefore, the aim of this study was to compare isolated apophyseal screw fixation and additional fixation techniques in Ogden fractures.

Methods: Two different types of apoepiphyseal tibial tubercle avulsion fractures were created in 40 proximal tibiae according to the modified Ogden classification: (1) Ogden type IIIA and (2) Ogden type IV.

Restriction of Posterior Tibial Translation During the Posterior Drawer Test in Internal or External Rotation Is Dependent on Peripheral Stabilizers of the Knee: A Biomechanical Robotic Investigation.

Background: The posteromedial and posterolateral structures of the knee have previously been shown to be secondary restraints to posterior tibial translation (PTT). The effect of these structures may increase when performing the posterior drawer test in internal or external rotation.

Purpose/hypothesis: The purpose was to investigate the influence of the posteromedial and posterolateral structures on restricting PTT in neutral, external, and internal rotation.

The central fibre areas in the tibial footprint of the posterior cruciate ligament show the highest contribution to restriction of a posterior drawer force-A biomechanical robotic investigation.

Purpose: The purpose of this study was to determine the role of different fibre areas of the tibial footprint of the posterior cruciate ligament (PCL) in restraining posterior tibial translation.

Methods: A sequential cutting study on cadaveric knee specimens ( = 8) was performed, utilizing a six-degrees-of-freedom robotic test setup. The tibial attachment of the PCL was divided into nine areas, which were sequentially cut in a randomized sequence.

Bilateral Iliosacral and Transsacral Screws Are Biomechanically Favorable and Reduce the Risk for Fracture Progression in Fragility Fractures of the Pelvis-A Finite Element Analysis.

(1) Background: The incidence of fragility fractures of the pelvis (FFP) has increased significantly over the past decades. Unilateral non-displaced fractures, defined as FFP II, are the most common type of fracture. When conservative treatment fails, surgical treatment is indicated.

Stress radiography of medial knee instability provides a reliable correlation with the severity of injury and medial joint space opening-A robotic biomechanical cadaveric study.

Purpose: The medial collateral ligament (MCL), and posterior oblique ligament (POL) are the primary valgus stabilisers of the knee, and clinical examinations in grading valgus instability can be inherently subjective. Stress radiography of medial-sided knee injuries provides objective diagnosis and was analysed in this study. We hypothesised that (1) medial joint space opening would increase cutting the superficial MCL (sMCL), POL and anterior cruciate ligament (ACL); (2) isolated deep MCL (dMCL) injury would not increase medial joint space opening; (3) medial joint space opening would increase at higher flexion angles.

A flat posterior cruciate ligament reconstruction restores native knee kinematics, comparable to a double-bundle reconstruction-A biomechanical robotic investigation.

Purpose: To biomechanically evaluate a flat posterior cruciate ligament (PCL) reconstruction utilizing rectangular femoral bone tunnels.

Methods: Eight fresh-frozen human knee specimens were tested in a six-degrees-of-freedom robotic test setup. In each testing step, a force-controlled test protocol was performed, including 89 N posterior tibial translation (PTT) in neutral, internal and external rotation, from 0 to 90° of flexion.

Knotless Suture Anchors Display Favorable Elongation but an Inferior Ultimate Failure Load Versus Titanium Suture Anchors and All-Suture Anchors: A Biomechanical Comparison in a Porcine Model.

Background: Several types of suture anchors, which differ in their working principles, are available for fixation of ligamentous structures in knee surgery. How the choice of a suture anchor type influences the biomechanical stability of ligament fixation is largely unknown.

Purpose: To compare the biomechanical properties of different suture anchor designs regarding primary stability for tendon fixation and repair in medial collateral ligament (MCL) surgery.

Fixation of Takeuchi Type II/III lateral hinge fractures provides favourable stability of a medial open wedge high tibial osteotomy-A biomechanical study.

Purpose: To investigate the biomechanical consequences of osteosynthesis of lateral hinge fractures (LHFs) in medial open wedge high tibial osteotomy (MOWHTO).

Methods: Sixteen fresh-frozen human cadaveric proximal tibiae underwent MOWHTO fixed with an ipsilateral locking compression plate. The specimens were assigned to two clusters simulating LHFs according to the Takeuchi classification: (1) Type II fracture; and (2) Type III fracture.

Proximal tibial anatomical axis and anterior tibial cortex-based measurements of posterior tibial slope on lateral radiographs differ least from actual posterior tibial slope-A biomechanical study.

Purpose: To compare different measurement techniques of the posterior tibial slope (PTS) on lateral radiographs with the actual in situ PTS and evaluate the effect of tibial malrotation and image section length.

Methods: Actual PTS was measured on eight fresh-frozen tibiae using a portable 6-axis measuring arm with an accuracy of ±0.01°.

The Effect of C-Arm Position on Femoral Tunnel Placement in Medial Patellofemoral Ligament Reconstruction.

Background: Medial patellofemoral ligament (MPFL) reconstruction is a common treatment for patellar instability. Yet nearly 40% of revisions result from femoral tunnel misplacement. One reason may be the positioning of the C-arm relative to the knee.

Anterior Slope-Modifying Osteotomies Alter the Length Change Behavior of the Superficial Medial Collateral Ligament: A Biomechanical Study.

Background: Increased tibial slope has been shown to lead to higher rates of anterior cruciate ligament graft failure. A slope-decreasing osteotomy can reduce in situ anterior cruciate ligament force and may mitigate this risk. However, how this procedure may affect the length change behavior of the medial ligamentous structures is unknown.