Asia-Pacific Journal of Sport Medicine Arthroscopy Rehabilitation and Technology最新文献

Background

Objectives

Methods

Results

Conclusion

Background

Methods

Results

Conclusions

Trial registration

Background

Methods

Result

Conclusions

Background/Objective

Methods

Results

Conclusion

Background

Over recent years, more anterior cruciate ligament (ACL) ruptures in badminton players have occurred. Little is known about the injury mechanism in badminton. The hypothesis is that most ACL injuries occur with single leg landings on the non-dominant leg in the backhand side or with lunge movements in the forehand side on the dominant leg. To inform prevention strategies the aim of this study was to investigate the mechanism of ACL injuries in badminton, specifically if ACL injuries occur in certain positions on the badminton court and/or with certain movements. Secondary aims were to investigate differences among gender, age groups and between recreational and tournament players.

Methods

The study, ACL Denmark, investigate ACL ruptures in a cohort of 90.610 participants diagnosed between 2000 and 2018. Of those, 539 participants reported ACL rupture during badminton and filled in an online questionnaire in December 2021–January 2022 on the injury mechanism and other injury characteristics. Data is presented as numbers, percentage, means (SD) and median (IQR) with chi square test or Fischers exact test for dichotomous outcomes.

Results

Most participants played badminton (n = 435, 81 %) as primary sport and 155 (29 %) reported to play on a competitive level (Tegner score 8). The rear court (n = 285, 40 %) was the most frequent location of injury but with a high percentage on the front and midcourt (n = 154, 22 %). The rear court was more prevalent among players aged 18–29 (p < 0.001). The most prevalent movement preceding the ACL injury was the scissor kick jump on the rear court (100, 19 %) followed by lunge at the net (70, 13 %) and lunge at the rear court (69, 13 %). One hundred and six players (15 %) were injured preceded by a deceptive shot from the opponent. The dominant leg was mainly injured in the forehand side and the non-dominant leg mainly in the backhand side.

Conclusion

The most prevalent movement preceding the ACL injury was the lunge followed by the scissor kick jump. The rear court was the primary location of ACL injury in badminton and the dominant knee has a higher risk of injury in the forehand side and the non-dominant knee in the backhand side. More focus on the technical performance of lunge and scissor kick jumps and development of a badminton specific ACL injury prevention program is needed in badminton.

Background/objective

This study aimed to clarify the kinematics of bi-cruciate-retaining (BCR) total knee arthroplasty (TKA) by comparing the mechanical alignment (MA) and functional alignment (FA) methods and to evaluate differences between the two alignment methods.

Methods

The in vivo kinematics of 20 MA TKA and 20 FA TKA knees were investigated under fluoroscopy during squatting using a two-to three-dimensional registration technique. Accordingly, knee flexion angle, axial rotational angle, varus–valgus angle, anteroposterior translation of the medial and lateral low contact points of the femoral component relative to the tibial component and kinematic pathway were evaluated.

Results

No difference in the knee flexion angle was observed between the MA and FA TKA groups. Femoral external rotation was observed in both groups and no significant difference was observed. Significant varus alignment from extension to early flexion range was observed in the FA TKA group. The posterior translation of the medial side was smaller in the FA TKA group than in the MA TKA group. Conversely, no significant difference in the anteroposterior translation of the lateral side was observed. In the kinematic pathway, a medial pivot motion from 0° to 20° of flexion and a lateral pivot motion beyond 20° of flexion were observed in both groups.

Conclusion

During squatting in BCR TKA, the FA TKA group significantly showed varus alignment and smaller posterior translation of the medial side than the MA TKA group from extension to early flexion range.

Objectives

The purpose of our study was to compare (1) posterior cruciate ligament (PCL) laxity, (2) patient-reported outcome, and (3) complications after the all-inside PCL reconstruction (Al-PCLR) technique and conventional PCLR (CON-PCLR) technique at minimum 2-year follow-up. We hypothesized that AI-PCLR and CONV-PCLR would yield similar results in PCL laxity, patient-reported outcomes, and complications.

Method

A retrospective cohort study was conducted on patients who underwent PCLR with the Al-PCLR technique and CON-PCLR technique from 2012 to 2023 in a single hospital. Medical records were reviewed for patients’ demographic data, the technique of PCL reconstruction and complications. Patient-reported outcome scores, including International Knee Documentation Committee (IKDC), Tegner activity scale, and Lysholm score, as well as bilateral kneeling radiographs and physical examinations, were collected at least 2 years postoperatively.

Results

Included in the study were 24 patients: 11 who underwent the CON-PCLR technique (mean age 40.7 +years) and 13 who underwent Al-PCLR (mean age 34.3 + 12.9 years). Three patients in AI-PCLR group were lost to follow-up and one patient is the CON-PCLR group, a revision case, was excluded from the study.

Bilateral stress kneeling radiographs showed a similar side-to-side difference between two groups (CON-PCLR vs AL-PCLR: mean 7.5 ± 5.2 vs 5.8 ± 4.8 mm; P = 0.38) There were no statically significant differences between the two groups in postoperative IKDC (CON-PCLR vs AL-PCLR: 68.9 vs 73.9; P = 0.37), Lysholm (89.1 vs 94.1; P = 0.42), or Tegner activity (6 vs 6.4; P = 0.68) scores.

Conclusion

All-inside PCLR demonstrates comparable stability to Conventional PCLR, with satisfactory patient-report outcome at minimum 2 years follow up and low rate of complications in patients with multiligament knee injury.

Level of evidence: III Retrospective comparative study.

Introduction

Posterior tibial slope (PTS) plays a vital role in knee stability. PTS of more than 12° may be considered with increased strain on the native anterior cruciate ligament (ACL) fibers. To handle the instability caused by changes in PTS degree, Proximal Tibial Anterior Closing Wedge Osteotomy (PT-ACWO) is adopted by surgeons.

Methods

Between October 2015 and October 2019, our department conducted a retrospective analysis of patients who experienced anterior cruciate ligament reconstruction (ACLR) graft failures, with a particular focus on pathological PTS. The time from initial ACLR to revision ranged from 1 to 10 years, with a mean of 2.5 years. Radiological assessments of PTS were conducted, and outcomes were quantified using the International Knee Documentation Committee (IKDC) score, Lysholm score, and Tegner activity scale. The surgical technique and the use of 3D Patient-Specific Instrumentation (PSI) were outlined. Preoperative imaging included the use of Kirschner wires to establish tibial plateau reference points, and 3D-PSI was employed to guide the location and depth of the tibial osteotomy, which was performed obliquely. In a notable instance, a novel tibial tunnel was mapped out, and ortho-bridge system (OBS) fixation was utilized to ensure adequate space for the new tunnel.

Results

In a cohort of seven patients with a mean follow-up of 28.1 months, a significant reduction in PTS was noted postoperatively (median [interquartile range, IQR], from 15.27° [13.46°, 16.60°] to 6.25° [5.89°, 6.78°]; P = 0.002). IKDC score improved to 85.10 (80.25, 88.10), P < 0.001; the Lysholm score to 88.00 (73.00, 90.50), P < 0.001; and the Tegner score to 8.00 (7.20, 8.05), P = 0.025 at final follow-up. Skin incision healing delays occurred in two instances, yet achieved closure by six weeks. Radiographs at three months demonstrated faster bone healing in oblique osteotomies than transverse ones. Knee joint stability was maintained, with no additional complications or evidence of instability noted. Magnetic resonance imaging (MRI) confirmed graft integrity in all patients, without signs of enlargement or mispositioning at last observation.

Conclusion

An augmented PTS angle exceeding 12 may constitute a potential etiology for the failure of ACLR grafts. In such patients, the implementation of ACLR combined with PT-ACWO could mitigate the risk of surgical failure during initial ACLR or subsequent revision procedures.

Background/objective

Cartilage oligomeric matrix protein (COMP) has utility as a diagnostic marker for osteoarthritis (OA). Our previous study revealed that the serum COMP level can be used to detect early cartilage change in non-OA patients with anterior cruciate ligament (ACL)-deficiency. However, there are still no studies on detecting the progression of cartilage degeneration in early OA. The aim of present study was to investigate whether serum COMP can detect the progression of cartilage degeneration after ACL reconstruction in non-OA patients.

Methods

Patients without cartilage degeneration of early OA at ACL reconstruction and whose serum COMP levels could be measured were included in the study. Cartilage degeneration of early OA were defined as International Cartilage Repair Society (ICRS) grade 1 to 4 in more than 2 compartments or ICRS grade 2 to 4 in 1 compartment. The patients were divided into two groups: those who had cartilage degeneration of early OA at second-look arthroscopy (cartilage degeneration progression group) and those who did not (non-progression group), and the serum COMP values between the two groups were compared.

Results

Thirty-one patients were included. There were 8 cases (25.8 %) in progression group and 23 cases (74.2 %) in non-progression group. There were significant differences between the two groups regarding age and change in serum COMP level. In terms of the rate of change in COMP, an increase of more than 1.24-fold was the cut-off value for detecting the progression of cartilage degeneration.

Conclusions

In this study, the increase in serum COMP levels was significantly greater in progressed cartilage degeneration group than non-progression group after ACL reconstruction. Longitudinal serum COMP measurement could detect the progression of cartilage degeneration.

Level of evidence

Level Ⅲ, retrospective comparative study.

Background

This study aimed to evaluate bone union of the tibial tuberosity in patients undergoing medial opening wedge distal tibial tuberosity osteotomy (OWDTO). It was hypothesized that bone union of the tibial tuberosity could be associated with lateral hinge fractures (LHFs), but not thickness of the tibial tuberosity osteotomy.

Methods

Data of 61 consecutive patients who underwent OWDTO were retrospectively reviewed. Radiographic parameters of the lower limb and LHFs were evaluated. Thickness of the tibial tuberosity osteotomy and bone union of the tibial tuberosity were assessed at 1, 2, 3, 4, and 5 cm distal to the most proximal part of the tibial tuberosity on computed tomography. Bone union was assessed. Factors related to bone union of the tibial tuberosity were analyzed.

Results

There were 13 postoperative onset LHFs: all healed with conservative treatments within 6 months after surgery. The total score of bone union of the tibial tuberosity was 8.4 ± 2.1 points, which correlated with age, postoperative medial proximal tibial angle (MPTA), correction angle, and postoperative onset LHF (r = 0.307, 0.388, 0.275, and −0.624, respectively; p = 0.016, 0.002, 0.033, and <0.001, respectively). Regression coefficient for postoperative onset LHF, postoperative MPTA, and body mass index were −0.619 (p < 0.001), 0.285 (p = 0.003), and −0.227 (p = 0.021), respectively.

Conclusion

Postoperative onset LHFs, but not thickness of the tibial tuberosity osteotomy, were a risk factor for delayed union of the tibial tuberosity following OWDTO. Furthermore, to prevent delayed union of the tibial tuberosity, postoperative onset LHFs should be prevented.

Level of evidence

LEVEL III, Case-control study.