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Overview of the anterolateral complex of the knee

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World Journal of Clinical Cases 2022年第24期10卷 8474-8481页

作者： ignacio garcia-mansilla Juan Pablo Zicaro Ezequiel Fernando Martinez Juan Astoul Carlos Yacuzzi MatiasCosta-Paz Knee Surgery Hospital Italiano de Buenos AiresBuenos Aires 1199Argentina

In the last few years,much more information on the anterolateral complex of the knee has become *** has now been demonstrated how it works in conjunction with the anterior cruciate ligament(ACL)controlling anterolateral rotatory *** studies have shown that the anterolateral complex(ALC)has a role as a secondary stabilizer to the ACL in opposing anterior tibial translation and internal tibial *** is of utmost importance that surgeons comprehend the intricate anatomy of the entire anterolateral aspect of the *** most studies have only focused on the anterolateral ligament(ALL),the ALC of the knee consists of a functional unit formed by the layers of the iliotibial band combined with the anterolateral joint *** interest has also been given to imaging evaluation using magnetic resonance and several studies have targeted the evaluation of the ALC in the setting of ACL *** are inconsistent with a lack of association between magnetic resonance imaging evidence of injury and clinical *** ACL reconstruction may not always reestablish knee rotatory stability in patients with associated ALC *** such cases,additional procedures,such as anterolateral reconstruction or lateral tenodesis,may be *** are several techniques available for ALL *** options include the iliotibial band,gracilis or semitendinosus tendon autograft,or allograft.

关键词： Anterolateral complex Knee instability Anterolateral ligament Anterior cruciate ligament reconstruction

Revision anterior cruciate ligament reconstruction:Return to sports at a minimum 5-year follow-up

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World Journal of Orthopedics 2022年第9期13卷 812-824页

作者： Ezequiel Ortiz Juan Pablo Zicaro ignacio garcia mansilla Carlos Yacuzzi Matias Costa-Paz Knee Division Hospital Italiano de Buenos AiresCiudad Autónoma 1181Buenos AiresArgentina

BACKGROUND Between 43%and 75%of patients who undergo primary anterior cruciate ligament(ACL)surgery return to sport ***,after a revision ACL reconstruction(ACLR)the rate of return to sports is variable.A few publications have reported returns to sports incidence between 56%to 100%after revision *** To determine return to sports and functional outcomes after a single-stage revision ACLR with a 5-year minimum follow-up at a single *** All patients operated between 2010 and 2016 with a minimum 5 years of followup were *** of sport,intensity,frequency,expectation,time to return to sport and failure rate were ***,Tegner and International Knee Documentation Committee forms were evaluated prior to the first ACLR surgery,at 6 mo after primary surgery and after revision ACLR at 5 years minimum of *** stability was tested with the knee arthrometer test(KT-1000 knee arthrometer,Medmetric Corp).RESULTS A total of 41 patients who underwent revision ACLR during that period of time were contacted and available for *** patient age at time of revision was 29 years old[interquartile range(IQR):24.0-36.0],and 39(95.0%)were *** median time from revision procedure to follow-up was 70 mo(IQR:58.0-81.0).Regarding return to sports,16(39.0%)were at the same level compared to preinjury period,and 25 patients(61.0%)returned at a lower ***-three percent categorized the sport as very important and 37.0%as *** patient(2.4%)failed with a recurrent ACL *** preoperative Lysholm and(SD)16]and 50(SD 11),*** follow-up,mean Lysholm and subjective International Knee Documentation Committee scores were 89(SD 8)and 82(SD 9)(P=0.0001).Mean Tegner score prior to primary ACLR was 6.7(SD 1.3),5.1(1.5 SD)prior to revision ACLR and 5.6(1.6 SD)at follow-up(P=0.0002).Overall,knee arthrometer test measurement showed an average of 6 mm(IQR:4.0-6.0)side-to-side difference of displacement pri

关键词： Return to sport Revision anterior cruciate ligament Arthroscopy Knee Functional outcome

Failure rate,return-to-sports and magnetic resonance imaging after meniscal repair:119 patients with 7 years mean follow up

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世界骨科杂志:英文版 2023年第8期14卷 612-620页

作者： Juan Pablo Zicaro Nicolas Garrido ignacio garcia-mansilla Carlos Yacuzzi Matias Costa-Paz Department of Knee Hospital Italiano de Buenos AiresBuenos Aires 1109Argentina

BACKGROUND One of the most important factors to consider in relation to meniscal repair is the high failure rate reported in the existing *** To evaluate failure rates,return to sports(RTS)rate,clinical outcomes and magnetic resonance image(MRI)evaluation after meniscus suture repair for longitudinal tears at a minimum *** We conducted a retrospective review of meniscal repairs between January 2004 and December *** patients treated for longitudinal tears associated or not with an anterior cruciate ligament reconstruction(ACL-R)were *** ramp lesions,radial and root tears,associated with multiligament injuries,tibial fracture and meniscal allograft transplants were *** details and failure rate,defined as symptomatic patients who underwent a revision surgery,were *** isolated bucket handle tears(BHTs)were usually associated with higher failure rates,we compared BHTs and not BHTs associated or not with an *** 2014,the inside-out technique using cannulas and suture needles with 2-0 Tycron began to *** addition,the number of stitches per repair was *** view of differences in surgical technique,we compared two different cohorts:before and after *** recorded the RTS according to the level achieved and the time to *** and IKDC scores were *** were studied with x-rays and MRI as standard postoperative *** One hundred and nineteen patients were included with a mean follow up of 7 years(SD:4.08).Overall failure rate was 20.3%at a mean 20.1 *** statistically significant differences were found when comparing failure for medial and lateral meniscal repair(22.7%and 15.3%,P=0.36),BHTs and not BHTs(26%and 17.6%,P=0.27),isolated or associated with an ACL-R(22.9%and 18%,P=0.47),or when comparing only BHTs associated with an ACL-R(23%and 27.7%,P=0.9)or *** comparing cohorts before and after 2014,we found a significant decrease in the overall f

关键词： Meniscus repair Bucket handle tears Meniscal suture Failure rate Longitudinal meniscus tears

Clinical,imaging,arthroscopic,and histologic features of bilateral anteromedial meniscofemoral ligament:A case report

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World Journal of Methodology 2023年第4期13卷 359-365页

作者： Juan Bautista Luco Damian Di Memmo Valentina Gomez Sicre Tomas ignacio Nicolino Matias Costa-Paz Juan Astoul ignacio garcia-mansilla Division of Knee Department of OrthopaedicsHospital Italiano de Buenos AiresBuenos Aires 1181Argentina Department of Radiology Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina Department of Pathology Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina

BACKGROUND The anteromedial meniscofemoral ligament(AMMFL)is a very rare entity,commonly unrecognized and *** it was not proved to be a cause of anterior knee pain,concerns have been raised on the relationship between the presence of this structure and medial meniscus injury secondary to its abnormal *** histologic examination,some studies have shown meniscus-like fibrocartilage,while others have identified it as ligament-like collagenous fibrous connective *** SUMMARY We report the case of a 34-year-old ballerina with an AMMFL associated with a torn medial meniscus of both *** was performed to treat the meniscal injury and two biopsies of each AMMFL were taken in different locations to define the histopathological *** examination revealed fibrocartilaginous tissue compatible with ***-up evaluation one year after surgery evidenced full remission of symptoms and the patient had resumed her athletic *** Clinical,magnetic resonance imaging,arthroscopic,and histological features have been carefully described to better characterize the AMMFL.

关键词： Meniscofemoral Ligaments Knee arthroscopy Histology Case report

Has platelet-rich plasma any role in partial tears of the anterior cruciate ligament?Prospective comparative study

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World Journal of Orthopedics 2021年第6期12卷 423-432页

作者： Juan Pablo Zicaro ignacio garcia-mansilla Andres Zuain Carlos Yacuzzi Matias Costa-Paz Knee Division Hospital Italiano de Buenos AiresBuenos Aires 1181Argentina

BACKGROUND Partial tears of the anterior cruciate ligament(ACL)are frequent,and there is still considerable controversy surrounding their diagnosis,natural history and *** To examine patient-reported outcomes,physical examination and magnetic resonance imaging(MRI)findings of partial ACL tears treated with an intraarticular injection of platelet-rich plasma(PRP)compared to a control *** From January 2015 to November 2017,consecutive patients from a single institution with partial ACL tears treated nonoperatively were prospectively *** tears were defined as a positive Lachman test with a clear endpoint,a negative pivot-shift and less than 3 mm of side-to-side difference using the KT1000 *** in group 1 were treated with one intraarticular injection of PRP and specific physical therapy *** group consisted of patients treated only with physical *** analyzed data included physical examination,Tegner activity level and Lysholm and International Knee Documentation Committee *** MRI findings and at 6 mo follow-up were *** was defined as those patients with clinical instability at follow-up that required a subsequent ACL *** A total of 40 patients where included,21 treated with PRP injection with a mean follow-up of 25 mo[standard deviation(SD):3.6]and 19 in the control group with a mean follow-up of 25 mo(SD:5.68).Overall failure rate was 32.0%(n=13).No significant differences were observed between groups regarding subjective outcomes,return to sport and failure *** findings revealed an improvement in the ACL signal in half of the patients of both ***,we did not find a significant relationship between MRI findings and clinical *** Overall,95.0%of patients returned to sports at a mean follow-up of 25 *** time to return to sports was 4 *** of these patients,almost 30.0%in each group had a new episode of instability

关键词： Anterior cruciate ligament Partial tears Platelet-rich plasma Non-operative treatment

Successful hip revision surgery following refracture of a modern femoral stem using a cortical window osteotomy technique:A case report and review of literature

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World Journal of Methodology 2023年第5期13卷 502-509页

作者： Carlos M Lucero Juan B Luco Agustin garcia-mansilla Pablo A Slullitel Gerardo Zanotti Fernando Comba Martin A Buttaro Centro de Cadera"Sir John Charnley" Instituto de Ortopedia y Traumatologia Prof.Dr.Carlos E.OttolenghiHospital Italiano de Buenos AiresCapital federal C1198AAWBuenos AiresArgentina Instituto de Ortopedia y Traumatologia Prof.Dr.Carlos E.Ottolenghi Hospital Italiano de Buenos AiresCiudad Autonoma de Buenos Aires C1198AAWBuenos AiresArgentina Centro de Cadera"Sir John Charnley" Instituto de Ortopedia y Traumatología“Prof.Dr.Carlos E.Ottolenghi”Hospital Italiano de Buenos AiresCiudad Autónoma de Buenos Aires C1198AAWBuenos AiresArgentina

BACKGROUND The ExeterTM Universal cemented femoral component is widely used for total hip replacement *** there have been few reports of femoral component fracture,removal of a broken femoral stem can be a challenging *** SUMMARY A 54-year-old man with a Dorr A femur sustained a refracture of a primary ExeterTM stem,two years after receiving a revision using a cement-within-cement technique(CWC)through an extended trochanteric osteotomy(ETO).The technical problems related to the CWC technique and the ETO played a major role in the stem fatigue *** performed revision surgery and removed the distal cement using a cortical femoral window technique,followed by reimplantation with an uncemented,modular,distally-fixed uncemented *** patient experienced an uneventful postoperative *** Re-fracture of a modern femoral ExeterTM stem is a rare event,but technical complications related to revision surgery can lead to this *** cortical window osteotomy technique can facilitate the removal of a broken stem and cement,allowing for prosthetic reimplantation under direct vision and avoiding ETO-related complications.

关键词： Exeter stem Femoral stem breakage Femoral osteotomy Total hip arthroplasty Case seport

Effectiveness of dry needling on reducing pain intensity in patients with myofascial pain syndrome： a Meta-analysis

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Journal of Traditional Chinese Medicine 2016年第1期36卷 1-13页

作者： Juan Rodriguez-mansilla Blanca Gonzalez-Sanchez Alvaro De Toro garcia Enrique Valera-Donoso Elisa Maria Garrido-Ardila Maria Jimenez-Palomares Maria Victoria Gonzalez Lopez-Arza Department of Medicine and Surgery University of Extremadura School of MedicineAdolor Research Group of the University of ExtremaduraBadajoz 06006Spain IMC Physiotherapy clinic Department of Physiotherapy.Caceres 10001Spain Physical and Rehabilitation Medicine Department Complutense University School of MedicineMadrid 28040Spain

OBJECTIVE: To summarize the literature about the effectiveness of dry needling(DN) on relieving pain and increasing range of motion(ROM) in individuals with myofascial pain syndrome(MPS).METHODS: Papers published from January 2000 to January 2013 were identified through an electronic search in the databases MEDLINE, Dialnet, Cochrane Library Plus, Physiotherapy Evidence Database(PEDro) and Spanish Superior Council of Scientific Research(CSIC). The studies included were randomized controlled trials written in English and/or Spanish about the effectiveness of DN on pain and ROM in individuals with ***: Out of 19 clinical trials that were potentially relevant, a total of 10 were included in the Meta-analysis. Regarding pain intensity reduction when measured before and immediately after the intervention, DN achieved improvement compared with the placebo treatment [d =-0.49; 95% CI(-3.21, 0.42)] and with the control group [d =-9.13;95% CI(- 14.70,- 3.56)]. However, other treatments achieved better results on the same variable compared with DN, considering the measurements for pre-treatment and immediately after [d = 2.54;95% CI(-0.40, 5.48)], as well as the pre-treatment and after 3-4 weeks [d = 4.23; 95% CI(0.78, 7.68)].DN showed a significantly increased ROM when measured before the intervention and immediately after, in comparison with the placebo [d = 2.00;95% CI(1.60, 2.41)]. However, other treatments achieved a significant better result regarding ROM when it was measured before the intervention and immediately after, as compared with DN [d =-1.42;95% CI(-1.84,-0.99)].CONCLUSION: DN was less effective on decreasing pain comparing to the placebo group. Other treatments were more effective than DN on reducing pain after 3-4 weeks. However, on increasing ROM,DN was more effective comparing to that of placebo group, but less than other treatments.

关键词：中医理论预防养生