Current Issue : October-December Volume : 2025 Issue Number : 4 Articles : 5 Articles
Background and Objectives: The anterior cruciate ligament (ACL) is crucial for knee stability, preventing anterior displacement of the tibia and rotation relative to the femur. Despite ACL reconstruction (ACLR), residual instability is common, affecting knee function. Anterolateral ligament reconstruction (ALLR) alongside ACLR improves outcomes, as the ALL plays a significant role in rotational stability. This study aims to assess the clinical and functional outcomes of the ACLR+ALLR combination using biomechanical testing in patients with at least ten months of follow-up. Materials and Methods: This cross-sectional comparative cohort study involves patients with ACLR. Inclusion criteria were adult patients who underwent ACLR within the last 3 years, with the same surgical technique performed by a single operator. Patients underwent anamnestic and clinical evaluation and completed Lysholm and KOOS questionnaires. Biomechanical tests included a Unilateral Drop Jump, a Countermovement Jump with knee rotation, and a five-repetition Sit-To-Stand. Force platforms, a camera, and surface electromyography were used to assess biomechanical stability and joint function. Results: This study included 18 subjects, 5 with ACLR and ALLR, and 13 with ACLR alone. The groups showed no significant differences in the KOOS and Lysholm scales and clinical outcomes. Muscle trophism reduction compared to the contralateral limb was noted in both groups. Biomechanical evaluations showed no difference in Quadriceps muscle activity during the landing phase of the Drop Jump. However, the ACL-ALL group exhibited fewer spikes and fewer knee joint angular excursions during ground impact stabilization. In the 5-STS task, a significant difference was observed in the vertical force peak. Differences in muscle activity during foot rotation and force components during the jumping phase were noted in the Countermovement Jump. Conclusions: ACLR combined with ALLR shows similar perceived joint function but improved biomechanical joint stability. Further studies with larger samples and longer follow-ups are needed for validation....
Background and Objectives: Infrapatellar fat pad impingement syndrome (IFPIS) is a relatively underdiagnosed cause of anterior knee pain. While conservative management is the initial approach, some patients require surgical intervention. This study aimed to evaluate the long-term clinical and radiologic outcomes following arthroscopic resection of the infrapatellar fat pad in patients with IFPIS. Materials and Methods: Eighteen patients (10 females, 8 males; median age 22) diagnosed with IFPIS and unresponsive to conservative therapy underwent arthroscopic partial or subtotal resection between 2007 and 2013. Diagnosis was based on physical examination (Hoffa’s test), MRI findings, and response to lidocaine injection. Clinical outcomes (VAS, IKDC-2000, Kujala, Lysholm, Tegner activity scores) and radiologic assessments (ISR, CDI, PFJ osteoarthritis grade) were evaluated preoperatively, at 2 years, and at a final follow-up (mean 148.7 months). Results: All clinical scores significantly improved postoperatively. VAS decreased from 7.25 ± 0.79 to 2.43 ± 1.50 at 2 years, and to 3.66 ± 1.50 at the final follow-up (p < 0.001). Similar long-term improvements were observed in the Kujala, IKDC-2000, Lysholm, and Tegner scores (all p < 0.001). Radiographic parameters including ISR and CDI remained stable, and there was no statistically significant progression in patellofemoral osteoarthritis. However, 5 of 18 patients (27.8%) reported persistent symptoms at long-term follow-up. Conclusions: Arthroscopic resection of the infrapatellar fat pad in patients with IFPIS showed favorable and sustained clinical outcomes over a 10-year follow-up, without significant radiological changes. These results suggest that arthroscopic resection is a viable treatment option when accurate diagnosis is established....
Background and Objectives: Distal radius fractures are among the most common pediatric injuries, accounting for approximately 25% of all fractures in children. Displaced fractures are prone to re-displacement, necessitating additional interventions. K-wire fixation is effective in reducing re-displacement risks, but no one has systematically assessed its use. This study aims to compare the outcomes of cast immobilization alone versus cast immobilization with K-wire fixation in pediatric patients with displaced distal radius fractures. Methods: A comprehensive search of PubMed,Web of Science, Cochrane CENTRAL, Scopus, and Embase databases for studies comparing these treatments. The quality assessment was conducted using the Cochrane Collaboration Risk of Bias for randomized studies and the Methodological Index for non-randomized studies. The meta-analysis was carried out using RevMan software V5.4. Results: Out of 267 initial records, 12 studies met the inclusion criteria, encompassing 1455 patients (853 treated with cast alone and 602 with K-wire fixation). Meta-analysis of 10 studies showed significantly higher re-displacement rates with cast immobilization compared to K-wire fixation (OR: 11.42, 95% CI: 2.43–53.77, p = 0.002, I2 = 82%). The risk of secondary surgery was also higher in the cast group (OR: 6.91, 95% CI: 1.5–31.72, p = 0.01, I2 = 75%). However, complications were lower with cast immobilization (OR: 0.68, 95% CI: 0.45–1.03, p = 0.07, I2 = 74%), though not statistically significant. Conclusions: K-wire fixation appears to offer superior fracture stability and reduces the need for secondary surgeries compared to cast immobilization for displaced distal radius fractures in pediatric patients. However, both treatment modalities are associated with comparable complication rates, emphasizing the importance of individualized treatment planning....
Background: Anterior cruciate ligament (ACL) rupture is one of the most common injuries in playing rugby. The aim of this study was to assess the effect of a customdesigned training program on changes in dynamic knee valgus angle (DKV) and Reactive Strength Index (RSI), which are the main risk factors, in a group of female Rugby-7 players. Methods: A total of 16 professional Rugby-7 players completed an 8-week KAT program intervention, which was incorporated twice a week throughout this time. In both the pre- and post-tests, dynamic knee valgus was assessed during the drop jump (DJ) test using the frontal plane projection angle (FPPA) method. The jumps were analyzed using Dartfish 2024 software. Results: The post-tests revealed an increase in RSI values (p = 0.0496; SD = 1.25 ± 0.44 vs. 1.40 ± 0.35) and a reduction in valgus of the left knee joint (p = 0.01; SD = 9.08 ± 11.86 vs.0.00 ± 7.42). The correlation between RSI and the valgus angle produced inconclusive results (rs = −0.69; p < 0.01; rs = −0.35; p = 0.25; rs = −0.38; p = 0.2; rs = −0.2; p = 0.51). Cohen’s d = −0.37964. Conclusions: The training program proved effective in improving RSI scores and reducing the valgus angle of the left lower limb, which functioned as the supporting leg. These findings potential KAT implementation as a warm-up routine in professional women’s rugby clubs....
Background: Total knee arthroplasty (TKA) is a widely performed procedure to alleviate pain and restore function in patients with advanced knee osteoarthritis. Two common implant designs are cruciate-retaining (CR) and posterior-stabilized (PS) knees. Despite extensive research, the superiority of one design over the other remains inconclusive. Methods: A prospective analysis was conducted on 123 patients who underwent total knee arthroplasty (TKA) between June 2022 and June 2023 at a university hospital. Demographic data, mobility, the use of walking aids, pre- and postoperative range of motion and leg axis as well as surgical and systemic complications were collected and compared between CR and PS-TKA. Results: The mean age of the patients was 67.94 ± 10.14 years and 65.9% were women. The time of operation was significantly different between PS- and CR-TKA (PS: 83.31 ± 25.65 min; CR: 95.26 ± 24.61 min; p = 0.011). The pre- to postoperative leg axis after six months was significantly different in both groups (PS: 7.06◦ ± 4.76◦; CR: 6.25◦ ± 3.13◦; p = 0.001). The range of motion (ROM) (PS: 105.19◦ ± 15.56◦; CR: 93.29◦ ± 15.09◦; p = 0.001) as well as the deficit after six months (PS: 23.56◦ ± 19.73◦; CR: 37.57◦ ± 23.33◦; p = 0.003) between patients with PS and CR-TKA were significantly different. Gender (male vs. female PS/CR) and age (<75 years vs. >75 years PS/CR) differences were shown for the ROM and flexion deficit after six months (p = 0.003; p = 0.005). For age, a significant difference was shown for the quality of life (mean ranks: <75 y: 47.96; >75 y: 31.03; p = 0.009) and WOMAC score (mean ranks: <75 y: 38.27; >75 y: 61.75; p = 0.001) after six months. Conclusions: This study shows the different outcomes for posterior-stabilized versus cruciate-retaining TKA with regard to time of surgery, range of motion, and flexion deficit after 6 months with PS-TKA yielding better results. The gender analyses revealed similar outcomes after six months between both arthroplasty groups, whereas the age analyses revealed significant differences. The standardized use of PS-TKA for the elderly is recommended....
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