Telerehabilitation After Anterior Cruciate Ligament Reconstruction Is Effective in Early Phases of the Recovery Programme.

: In recent years, scientific literature has illustrated the growing interest in telerehabilitation after ACL reconstruction. The aim of this study is to compare the effectiveness of remotely supervised rehabilitation with traditional supervised rehabilitation after ACLR, focusing on objective postoperative functional assessment outcomes. : A retrospective analysis of prospectively collected data was carried out, selecting patients that underwent arthroscopic ACLR by a single surgeon.

Early versus standard return to play following ACL reconstruction: impact on volume of play and career longevity in 180 professional European soccer players: a retrospective cohort study.

Background: Patients typically follow a 7-9-month return to play (RTP) protocol following anterior cruciate ligament reconstruction (ACLR); however, much of these data have been based on non-elite athletes. The purpose of this study is to understand whether professional soccer players returning to competition < 6-months following ACLR will have an increased risk of graft failure, play fewer seasons postoperatively, and have lower volume of play compared with those returning > 6 months.

Materials And Methods: A total of 180 male professional European soccer players were enrolled and underwent ACLR with a single surgeon between April 2008 and December 2016 and returned to sport < 6 months (early RTP group, n = 92) or > 6 months (standard RTP group, n = 88).

Concomitant Popliteomeniscal Fascicles Tears Are Found in 21% of Professional Soccer Players With Acute Anterior Cruciate Ligament Injuries.

Purpose: To investigate the incidence of popliteomeniscal fascicles (PMF) tears in anterior cruciate ligament (ACL) rupture in professional soccer players, to describe arthroscopic and magnetic resonance imaging (MRI) findings and treatment of these lesions with clinical outcomes, and to evaluate the incidence of subsequent lateral meniscus tears and ACL reinjury.

Methods: ACL reconstructions on soccer players were retrospectively analyzed, and among them, a cohort of patients with PMFs tears was reviewed. The cohort was assessed with MRI examination, arthrometric testing, Lysholm score, and International Knee Documentation Committee score.

Autograft Choice and Jumping Performance After Anterior Cruciate Ligament Reconstruction: A Comparative Study on Professional Athletes.

Background: The extensor apparatus of the knee is of paramount importance in generating the torque needed for a countermovement jump (CMJ), especially in jumping athletes. In anterior cruciate ligament reconstruction (ACLR) procedures, graft harvesting from the extensor apparatus may dramatically affect extensor strength and jumping performance.

Hypothesis: The focused jump training of professional jumping athletes would increase the likelihood of restoring jumping performance after ACLR, despite the graft choice (autologous bone-patellar tendon-bone [BPTB] or hamstring [HS] tendon).

Semimembranosus Tendon Findings in Acute Anterior Cruciate Ligament Tears: MRI Evaluation and Associated Lesions.

Background: The semimembranosus (SM) tendon acts as a secondary dynamic stabilizer of the knee. It restrains external rotation and anterior translation of the medial compartment. Its role in the mechanism of injury during anterior cruciate ligament (ACL) rupture is unknown.

Meniscus tears treatment: The good, the bad and the ugly-patterns classification and practical guide.

Over the years, several studies demonstrated the crucial role of knee menisci in joint biomechanics. As a result, save the meniscus has become the new imperative nowadays, and more and more studies addressed this topic. The huge amount of data on this topic may create confusion in those who want to approach this surgery.

Imaging of Anatomical Variants Around the Knee.

Several anatomical variants have been described in the knee. These variants may involve intra- and extra-articular structures, such as menisci, ligaments, plicae, bony structures, muscles, and tendons. They have a variable prevalence, are generally asymptomatic, and are usually discovered incidentally in knee magnetic resonance imaging examinations.

Early Superimposed NMES Training is Effective to Improve Strength and Function Following ACL Reconstruction with Hamstring Graft regardless of Tendon Regeneration.

The study aimed at investigating the effects of neuromuscular electrical stimulation superimposed on functional exercises (NMES+) early after anterior cruciate ligament reconstruction (ACLr) with hamstring graft, on muscle strength, knee function, and morphology of thigh muscles and harvested tendons. Thirty-four participants were randomly allocated to either NMES+ group, who received standard rehabilitation with additional NMES of knee flexor and extensor muscles, superimposed on functional movements, or to a control group, who received no additional training (NAT) to traditional rehabilitation. Participants were assessed 15 (T1), 30 (T2), 60 (T3), 90 (T4) and at a mean of 380 days (T5) after ACLr.

The post-traumatic meniscal extrusion, sign of meniscotibial ligament injury. A case series.

Background: Medial meniscal extrusion (ME) has been found to be associated to anterior cruciate ligament (ACL) injury. Post-traumatic extrusion is mainly attributed to meniscotibial ligament (MTL) tear. The aim of this retrospective study was to assess the incidence of MTL tear associated with meniscal extrusion, evaluate arthroscopic findings and the associated clinical findings.

A Countermovement Jump for the Midterm Assessment of Force and Power Exertion After Anterior Cruciate Ligament Reconstruction.

Objective: The aim of this study was to assess force and power exertion during a countermovement jump after anterior cruciate ligament reconstruction using either semitendinosus and gracilis or bone-patellar tendon-bone graft.

Design: One hundred-nineteen semitendinosus and gracilis and 146 bone-patellar tendon-bone participants performed a countermovement jump on two force platforms after 3 (T1) and 6-9 mos (T2) from surgery. Twenty-four healthy participants served as control group.

Deficit in knee extension strength following anterior cruciate ligament reconstruction is explained by a reduced neural drive to the vasti muscles.

The persistence of quadriceps weakness represents a major concern following anterior cruciate ligament reconstruction (ACLR). The underlying adaptations occurring in the activity of spinal motoneurons are still unexplored. This study examined the discharge patterns of large populations of motor units (MUs) in the vastus lateralis (VL) and vastus medialis muscles following ACLR.

Anomalous insertion of anterior and posterior horns of medial meniscus. Case report.

Background: Anatomical variations of the attachment of medial meniscus are a common finding. However, anomalies of the posterior horn are extremely rare. Only two cases of posterior root anomaly have been described prior to the routine use of arthroscopy for evaluation and treatment of meniscal pathology.

Arthroscopic incidence of lateral meniscal root avulsion in patients with anterior cruciate ligament injury.

Background: To arthroscopically evaluate the incidence of lateral meniscal root avulsion (LMRA) and associated intra-articular injuries in patients undergoing anterior cruciate ligament (ACL) reconstruction.

Materials And Methods: From April 2014 to March 2017, 532 consecutive patients were diagnosed as having an ACL injury and underwent arthroscopic ACL reconstruction. The diagnosis of LMRA was made arthroscopically.

Meniscal ramp lesions: diagnostic performance of MRI with arthroscopy as reference standard.

Background: The posteromedial meniscal region is gaining interest among orthopedic surgeons, as lesions of this area has been reported to be significantly associated with anterior cruciate ligament tears. The current imaging literature is unclear.

Purpose: To evaluate the diagnostic performance of MR in the detection of meniscal ramp lesions having arthroscopy as reference standard.

Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction.

Background: The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR).

Purpose/hypothesis: The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise.

Muscle fiber conduction velocity in the vastus lateralis and medialis muscles of soccer players after ACL reconstruction.

The neural factors underlying the persistency of quadriceps weakness after anterior cruciate ligament reconstruction (ACLR) have been only partially explained. This study examined muscle fiber conduction velocity (MFCV) as an indirect parameter of motor unit recruitment strategies in the vastus lateralis (VL) and medialis (VM) muscles of soccer players with ACLR. High-density surface electromyography (HDsEMG) was acquired from VL and VM in nine soccer players (22.

Quadriceps muscle compensatory activations are delayed following anterior cruciate ligament reconstruction using hamstring tendon graft.

Background: Compensatory and anticipatory quadriceps activation (CQA and AQA) in response to postural perturbations are essential for functional stability of the knee. This study aimed at investigating CQA and AQA before and after anterior cruciate ligament reconstruction (ACLR) using hamstrings graft.

Methods: Twelve participants with ACLR and 12 healthy controls were exposed to 10 either unpredictable or predictable perturbations of the knee before ACLR (T1), two months (T2) and six months (T3) after surgery.

No Relationship Between Preoperative and Early Postoperative Strength After ACL Reconstruction.

Context: All rehabilitative programs before anterior cruciate ligament (ACL) reconstructive surgery, which are focused on recovery of proprioception and muscular strength, are defined as prehabilitation. While it has shown that prehabilitation positively affects the overall outcome after ACL reconstruction, it is still controversial whether preoperatively enhancing quadriceps strength has some beneficial effect on postoperative strength, mainly during the first period.

Objective: To determine whether there is any relationship between preoperative and early postoperative quadriceps strength.

The 45 degrees arthroscope: A forgotten scope in knee surgery.

The majority of knee arthroscopic procedures are performed with 30° scope while the 70° arthroscope is mainly used for surgery of posterior compartments. In the arthroscopic armamentarium, another scope, unknown to many surgeons, is also available: the 45° arthroscope. His field of view provides a wider intraoperative view than that of a 30° scope without the characteristic blind spot of a 70° scope.

Timing of Muscle Activation Is Altered During Single-Leg Landing Tasks After Anterior Cruciate Ligament Reconstruction at the Time of Return to Sport.

Objectives: It is well known that alterations in landing mechanics persist for years after anterior cruciate ligament reconstruction (ACL-R). Nevertheless, existing literature is controversial in reporting successful or unsuccessful recovery of prelanding muscle activation timing after ACL-R. The study aimed at comparing myoelectric and kinematic patterns during landing tasks between ACL-R and healthy subjects.

Postural Adjustments Following ACL Rupture and Reconstruction: A Longitudinal Study.

Longitudinal changes in compensatory and anticipatory postural adjustments around the knee were investigated from rupture of ACL until return to play after reconstruction. Twelve ACL-injured participants (ACL-P) were asked to respond to unpredictable and predictable perturbations before (T1), 2 (T2) and 6 months after (T3) reconstruction. Twelve healthy participants served as controls.

Italian consensus statement for the use of allografts in ACL reconstructive surgery.

Purpose: Graft choice for primary anterior cruciate ligament reconstruction (ACL-R) is debated, with considerable controversy and variability among surgeons. Autograft tendons are actually the most used grafts for primary surgery; however, allografts have been used in greater frequency for both primary and revision ACL surgery over the past decade. Given the great debate on the use of allografts in ACL-R, the "Allografts for Anterior Cruciate Ligament Reconstruction" consensus statement was developed among orthopedic surgeons and members of SIGASCOT (Società Italiana del Ginocchio, Artroscopia, Sport, Cartilagine, Tecnologie Ortopediche), with extensive experience in ACL-R, to investigate their habits in the use of allograft in different clinical situations.

MRI of popliteo-meniscal fasciculi of the knee: a pictorial review.

The popliteomeniscal fascicules (PMFs) provide the attachment of the lateral meniscus to the popliteus musculotendinous region, forming the floor and the roof the popliteal hiatus. In the second half of 1900's, some anatomic studies claim the important function of the PMF as stabilizers of the lateral meniscus; these anatomical structures work in conjunction with the popliteus musculotendinous unit to prevent excessive lateral meniscal movement and possible meniscus subluxation. A correct diagnosis of the PMFs pathology is crucial to establish the suitable surgical treatment for each patient.

Neuromuscular Electrical Stimulation Superimposed on Movement Early after ACL Surgery.

Purpose: Quadriceps weakness and asymmetrical loading of lower limbs are two major issues after anterior cruciate ligament reconstruction (ACLR). The aim of this study was to evaluate the effectiveness of a 6-wk training protocol involving neuromuscular electrical stimulations (NMES) of the quadriceps muscle superimposed on repeated sit-to-stand-to-sit exercises (STSTS), as an additional treatment to standard rehabilitation, from the 15th to the 60th day after ACLR.

Methods: Sixty-three ACLR patients were randomly allocated to one of the three treatment groups: NMES superimposed on STSTS (NMES + STSTS), STSTS only, or no additional treatment (NAT) to standard rehabilitation.