Knee Medicine and Science

Acute knee MRI and x-ray pictures.

Great video presenting x-ray and MRI examination of an acute knee injury.
All rights reserved to the Radiology Channel.

BJSM Podcast: Tuning up rehabilitation after ACL reconstruction.

Another great talk from Dr Andre Franklyn – Miller. This time, he presents his approach to management of ACL in athletes. Definitely a must to listen for both, clinicians and ACL patients.

Listen here.

Best practice for primary isolated ACL reconstruction.

A consensus statement of best management in primary ACL rupture, provided by the British Orthopaedic Association.

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ACL injury.

The picture presents Jakub Błaszczykowski, a polish midfielder playing for Borussia Dortmund football club. He has recently ruptured his ACL which means that we will not see this talented player for the rest of current season. The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. The post will cover current concepts in regards to the causes, history, risk factors, diagnosis and treatment of the ACL tear.

Knee neurovascular evaluation.

Pain in the knee joint may be caused by several factors. One of them, is refereed pain form the lumbar spine, thus differentiation is crucial. In this video, Dr Mark Hutchinson presents neurovascular examination of the knee joint when there is suspicion of lumbar spine involvement.

Risk Factors for Meniscectomy After Meniscal Repair.

Risk Factors for Meniscectomy After Meniscal Repair.
Lyman, S., Hidaka, C., Valdez, A., Hetsroni, I., Jung Pan, T., Do, H., Dunn, W., and Marx, R. American Journal of Sports Medicine; 41: 2772 – 2778.
http://ajs.sagepub.com/content/41/12/2772.abstract

There is lack of clear evidence indicating rate of and risk factors for meniscectomy in patients following meniscal repair. This study was conducted to investigate these factors. Data including information on nearly 10 000 patients were retrospectively analyzed.
Authors found that overall frequency of subsequent meniscectomies was 8.9%. Patients who underwent concomitant ACL surgery were less susceptible to undergo meniscectomy. In patients who had isolated meniscal repair, older age, lateral meniscus injury and being operated by surgeon with a higher annual meniscal repair volume were factors decreasing risk of subsequent meniscectomy procedure.
All rights reserved to the American Journal of Sports Medicine.

20% of ACL reconstructed patients may need further surgeries.

The rate of subsequent surgery and predictors after anterior cruciate ligament reconstruction.
Hettrich, C., Dunn, W., Reinke, E., MOON group, and Spindler, K. Americna Journal of Sports Medicine, 2013; 41: 1534 – 1540.
http://ajs.sagepub.com/content/41/7/1534.abstract

Authors followed almost 1000 patients for few years after they underwent ACL reconstruction. The main aim of the study was to determine the rate at which following surgeries were required and to identify risk factors that predisposed for re – surgery among this sample.
At six year follow – up nearly 20% of participants required subsequent surgery on the ipsilateral knee while 10% underwent surgery on the contralateral knee. On the ipsilateral knee, cartilage procedures were most commonly performed (13%), followed by ACL revision surgery (7.7%). Young age at the time of initial surgery and the use of allografts were predictors for subsequent procedure. Revision ACLR, female sex, body mass index, and surgical exposure were not significant risk factors.