Pub Date : 2021-12-08DOI: 10.5772/intechopen.99952
N. Jagadeesh, Sachindra Kapadi, Venkatesh Deva, Ankur D. Kariya
An anterior cruciate ligament(ACL) is one of the major stabilizers of the knee joint, injury to which can be quite dreadful even ending many sports careers if not properly treated. Knowledge of the risk factors contributing to ACL injury will help in identifying at-risk individuals and develop preventive strategies. The factors contributing to ACL injury are multi-factorial involving biomechanical, anatomical, hormonal, neuromuscular factors etc; and can be broadly classified as Intrinsic and Extrinsic factors. Intrinsic factors are mostly non-modifiable risk factors may be subdivided into anatomical, genetic, gender, previous ACL Injuries etc . Whereas Extrinsic factors are mostly modifiable risk factors include environmental factors, characteristic of surface and shoe, BMI and others. Anatomical risk factors can divided into tibial parameters like posterior tibial slope, medial tibial plateau depth etc ; femoral parameters like notch width, notch index etc.
{"title":"Risk Factors of ACL Injury","authors":"N. Jagadeesh, Sachindra Kapadi, Venkatesh Deva, Ankur D. Kariya","doi":"10.5772/intechopen.99952","DOIUrl":"https://doi.org/10.5772/intechopen.99952","url":null,"abstract":"An anterior cruciate ligament(ACL) is one of the major stabilizers of the knee joint, injury to which can be quite dreadful even ending many sports careers if not properly treated. Knowledge of the risk factors contributing to ACL injury will help in identifying at-risk individuals and develop preventive strategies. The factors contributing to ACL injury are multi-factorial involving biomechanical, anatomical, hormonal, neuromuscular factors etc; and can be broadly classified as Intrinsic and Extrinsic factors. Intrinsic factors are mostly non-modifiable risk factors may be subdivided into anatomical, genetic, gender, previous ACL Injuries etc . Whereas Extrinsic factors are mostly modifiable risk factors include environmental factors, characteristic of surface and shoe, BMI and others. Anatomical risk factors can divided into tibial parameters like posterior tibial slope, medial tibial plateau depth etc ; femoral parameters like notch width, notch index etc.","PeriodicalId":122165,"journal":{"name":"Arthroscopy [Working Title]","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129229635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-21DOI: 10.5772/intechopen.99562
Deepak V. Patel, Iciar M. Dávila Castrodad, Jennifer Kurowicki, Vincent K. McInerney, Anthony J. Scillia
Recurrent patellofemoral instability is a common cause of knee pain and functional disability in adolescent and young adult patients, resulting in loss of time from work and sports. There are numerous factors that contribute to recurrent patellofemoral instability; these factors include tear of the medial patellofemoral ligament (MPFL), weakening or hypoplasia of the vastus medialis obliquus (VMO), trochlear dysplasia, increased tibial tuberosity-trochlear groove (TT-TG) distance (>20 mm), valgus malalignment, increased Q angle, malrotation secondary to internal femoral or external tibial torsion, patella alta, and generalized ligamentous laxity. A detailed history and a thorough physical examination are crucial to clinch an early, accurate diagnosis. Imaging studies play an important role to confirm the clinical diagnosis and also help to identify concomitant intra-articular pathologies. Initially, nonoperative management (including the use of physical therapy, patellar taping or brace) is offered to patients with acute, first-time patellar dislocations and most patients respond well to this mode of treatment. Surgical treatment is indicated for patients who have post-trauma osteochondral fracture or loose body; predisposing anatomical risk factors; recurrent, symptomatic instability; and who have failed an adequate trial of nonoperative management. Surgical treatments include MPFL reconstruction, proximal or distal realignment procedures, and trochleoplasty. Lateral release is often performed in combination with other procedures and seldom performed as an isolated procedure. An individualized case-by-case approach is recommended based on the underlying anatomical risk factors and radiographic abnormality.
{"title":"Patellofemoral Instability","authors":"Deepak V. Patel, Iciar M. Dávila Castrodad, Jennifer Kurowicki, Vincent K. McInerney, Anthony J. Scillia","doi":"10.5772/intechopen.99562","DOIUrl":"https://doi.org/10.5772/intechopen.99562","url":null,"abstract":"Recurrent patellofemoral instability is a common cause of knee pain and functional disability in adolescent and young adult patients, resulting in loss of time from work and sports. There are numerous factors that contribute to recurrent patellofemoral instability; these factors include tear of the medial patellofemoral ligament (MPFL), weakening or hypoplasia of the vastus medialis obliquus (VMO), trochlear dysplasia, increased tibial tuberosity-trochlear groove (TT-TG) distance (>20 mm), valgus malalignment, increased Q angle, malrotation secondary to internal femoral or external tibial torsion, patella alta, and generalized ligamentous laxity. A detailed history and a thorough physical examination are crucial to clinch an early, accurate diagnosis. Imaging studies play an important role to confirm the clinical diagnosis and also help to identify concomitant intra-articular pathologies. Initially, nonoperative management (including the use of physical therapy, patellar taping or brace) is offered to patients with acute, first-time patellar dislocations and most patients respond well to this mode of treatment. Surgical treatment is indicated for patients who have post-trauma osteochondral fracture or loose body; predisposing anatomical risk factors; recurrent, symptomatic instability; and who have failed an adequate trial of nonoperative management. Surgical treatments include MPFL reconstruction, proximal or distal realignment procedures, and trochleoplasty. Lateral release is often performed in combination with other procedures and seldom performed as an isolated procedure. An individualized case-by-case approach is recommended based on the underlying anatomical risk factors and radiographic abnormality.","PeriodicalId":122165,"journal":{"name":"Arthroscopy [Working Title]","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129934155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-09-05DOI: 10.5772/intechopen.99592
Matthew J. Brown
The preservation of the structure of the meniscus despite a tear has been widely discussed in the literature. However, meniscectomy continues to be the most-performed meniscus surgery. In a percentage of patients, knee pain and swelling, as well as tibial plateau bony edema, follow meniscus resection; this panoply of symptoms is known as “post-meniscectomy syndrome”. The management of this condition requires meniscus transplant in case of total meniscectomy or a meniscus scaffold in the case of a partial resection. This chapter aims to discuss the indication, surgical technique, and outcomes of collagen meniscus implants (CMI) for partial resections and meniscus transplants for full resections.
{"title":"The Meniscus Deficient Knee: Options for Repair and Reconstruction","authors":"Matthew J. Brown","doi":"10.5772/intechopen.99592","DOIUrl":"https://doi.org/10.5772/intechopen.99592","url":null,"abstract":"The preservation of the structure of the meniscus despite a tear has been widely discussed in the literature. However, meniscectomy continues to be the most-performed meniscus surgery. In a percentage of patients, knee pain and swelling, as well as tibial plateau bony edema, follow meniscus resection; this panoply of symptoms is known as “post-meniscectomy syndrome”. The management of this condition requires meniscus transplant in case of total meniscectomy or a meniscus scaffold in the case of a partial resection. This chapter aims to discuss the indication, surgical technique, and outcomes of collagen meniscus implants (CMI) for partial resections and meniscus transplants for full resections.","PeriodicalId":122165,"journal":{"name":"Arthroscopy [Working Title]","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132844640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-30DOI: 10.5772/intechopen.99593
C. Konrads, S. Döbele
Anterior inferior shoulder dislocation is a common injury. After primary traumatic shoulder dislocation and conservative treatment, the risk of re-dislocation is very high in patients younger than 35 years. With age, the risk of re-dislocation after traumatic shoulder dislocation and conservative treatment decreases. Surgical treatment via either open or arthroscopic stabilization minimizes the risk of re-dislocation. Today, anterior shoulder stabilization by arthroscopic refixation of the labroligamentous complex with suture anchors is a standard procedure, if there is no severe chronic bony defect at the glenoid site. Lafosse et al. described the so-called „Lasso-loop stitch“. This technique allows for positioning of the knot away from the joint and at the same time it establishes a labral bump that stabilizes the humeral head against (sub)luxation. The surgical principle and aim consist of refixation of the anterior labrum-capsule-ligament complex to the glenoid with positioning of the knot at distance to the joint as well as bulging up the labrum. This stabilizes the shoulder joint and therefore avoids further dislocations and associated pathologies. The aim of this work is to give an illustrated instruction of the surgical technique of arthroscopic Bankart repair using the lasso-loop stitch.
{"title":"Arthroscopic Bankart Repair Using a Lasso-Loop Stitch","authors":"C. Konrads, S. Döbele","doi":"10.5772/intechopen.99593","DOIUrl":"https://doi.org/10.5772/intechopen.99593","url":null,"abstract":"Anterior inferior shoulder dislocation is a common injury. After primary traumatic shoulder dislocation and conservative treatment, the risk of re-dislocation is very high in patients younger than 35 years. With age, the risk of re-dislocation after traumatic shoulder dislocation and conservative treatment decreases. Surgical treatment via either open or arthroscopic stabilization minimizes the risk of re-dislocation. Today, anterior shoulder stabilization by arthroscopic refixation of the labroligamentous complex with suture anchors is a standard procedure, if there is no severe chronic bony defect at the glenoid site. Lafosse et al. described the so-called „Lasso-loop stitch“. This technique allows for positioning of the knot away from the joint and at the same time it establishes a labral bump that stabilizes the humeral head against (sub)luxation. The surgical principle and aim consist of refixation of the anterior labrum-capsule-ligament complex to the glenoid with positioning of the knot at distance to the joint as well as bulging up the labrum. This stabilizes the shoulder joint and therefore avoids further dislocations and associated pathologies. The aim of this work is to give an illustrated instruction of the surgical technique of arthroscopic Bankart repair using the lasso-loop stitch.","PeriodicalId":122165,"journal":{"name":"Arthroscopy [Working Title]","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127365386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-29DOI: 10.5772/intechopen.99219
A. Góralczyk, P. Jancewicz, Krzysztof Hermanowicz
Injuries to the posterolateral corner (PLC) of the knee may have a devastating impact on whole joint. Posterolateral rotatory instability, despite getting more and more popular among orthopedic surgeons, still remains challenging to diagnose and even more challenging to treat. Available surgical techniques are demanding and require advanced surgical skills. In this chapter we are going to review the diagnostic tools which help to recognize posterolateral rotatory instability of the knee, to outline its importance and consequences of misdiagnosis as well as present arthroscopic popliteus tenodesis and arthroscopic-assisted posterolateral corner reconstruction which are our minimally invasive techniques used to treat this condition depending on PLC injury pattern and grading. Presented techniques are reproducible, safe and do not require advanced surgical skills being a useful alternative for available open PLC reconstructions.
{"title":"Injuries of the Posterolateral Corner of the Knee-Diagnosis and Treatment Options for Beginning and Advanced Arthroscopic Surgeons","authors":"A. Góralczyk, P. Jancewicz, Krzysztof Hermanowicz","doi":"10.5772/intechopen.99219","DOIUrl":"https://doi.org/10.5772/intechopen.99219","url":null,"abstract":"Injuries to the posterolateral corner (PLC) of the knee may have a devastating impact on whole joint. Posterolateral rotatory instability, despite getting more and more popular among orthopedic surgeons, still remains challenging to diagnose and even more challenging to treat. Available surgical techniques are demanding and require advanced surgical skills. In this chapter we are going to review the diagnostic tools which help to recognize posterolateral rotatory instability of the knee, to outline its importance and consequences of misdiagnosis as well as present arthroscopic popliteus tenodesis and arthroscopic-assisted posterolateral corner reconstruction which are our minimally invasive techniques used to treat this condition depending on PLC injury pattern and grading. Presented techniques are reproducible, safe and do not require advanced surgical skills being a useful alternative for available open PLC reconstructions.","PeriodicalId":122165,"journal":{"name":"Arthroscopy [Working Title]","volume":"108 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126974915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-07-13DOI: 10.5772/INTECHOPEN.98763
T. Itthipanichpong, Songthai Moonwong
This chapter mainly focuses on medial meniscus posterior root tear which is the point of attention nowadays because it is the common degeneration process and can lead to early-onset osteoarthritis of the knee without treatment. The biomechanics of the medial meniscus root tear is similar to total meniscectomy. Hence, early detection and diagnosis will lead to better outcome. Most cases with medial meniscus root tear also have degenerative change of the knee. Meniscal extrusion is a common finding in magnetic resonance imaging (MRI) which represent impairing of hoop stress function of the meniscus. Patient selection and understanding of the natural history of the disease is a particularly important. Options for the treatment including conservative treatment, surgical treatment such as partial meniscectomy, meniscus root repair, or reduction of meniscal extrusion. Outcome of these treatments are variable depending on the condition of the patients. Long term outcome of surgical treatment revealed lower rate of knee replacement compared with conservative treatment.
{"title":"Medial Meniscus Root Tear: Current Update Review","authors":"T. Itthipanichpong, Songthai Moonwong","doi":"10.5772/INTECHOPEN.98763","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.98763","url":null,"abstract":"This chapter mainly focuses on medial meniscus posterior root tear which is the point of attention nowadays because it is the common degeneration process and can lead to early-onset osteoarthritis of the knee without treatment. The biomechanics of the medial meniscus root tear is similar to total meniscectomy. Hence, early detection and diagnosis will lead to better outcome. Most cases with medial meniscus root tear also have degenerative change of the knee. Meniscal extrusion is a common finding in magnetic resonance imaging (MRI) which represent impairing of hoop stress function of the meniscus. Patient selection and understanding of the natural history of the disease is a particularly important. Options for the treatment including conservative treatment, surgical treatment such as partial meniscectomy, meniscus root repair, or reduction of meniscal extrusion. Outcome of these treatments are variable depending on the condition of the patients. Long term outcome of surgical treatment revealed lower rate of knee replacement compared with conservative treatment.","PeriodicalId":122165,"journal":{"name":"Arthroscopy [Working Title]","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128549304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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