Now in a revised and expanded second edition including ten new chapters, this classic text on the diagnosis and management of posterior cruciate ligament injuries represents the state of the art. Comprehensive and used-friendly, the book covers PCL anatomy and biomechanics, diagnosis and evaluation, and both surgical and non-surgical treatment strategies. Surgical chapters discuss graft selection and open and arthroscopic techniques, including both primary and revision surgery and combined reconstruction with other knee ligaments. New chapters illustrate cutting-edge and advanced surgical techniques in reconstruction and primary repair, articular cartilage resurfacing and meniscus transplant in the PCL injured knee, mechanical graft tensioning, the role of osteotomy, treatment of PCL injuries in children, results of treatment and outcomes data in PCL injuries, clinical case studies, and the editor’s experience chapter based on 24 years of treating PCL injuries. Complications, bracing and rehabilitation round out the presentation. Written and edited by leaders in the management of injuries to the knee, this will be an invaluable text for orthopedic surgeons and sports medicine practitioners alike.
The Multiple Ligament Injured Knee: A Practical Guide to Management includes the most developed knowledge needed to successfully diagnose and treat knee ligament injuries. This thorough work presents anterior and posterior cruciate and collateral ligament anatomy and biomechanics along with non-invasive methods for diagnosing the extent of injury, such as radiographic and arthroscopic evaluation. Various injuries are discussed in addition to useful treatment techniques, including arthroscopic reconstruction, posterolateral and posteromedial corner injury and treatment, assessment and treatment of vascular injuries, assessment and treatment of nerve injuries, rehabilitation, and post-operative results. Each of these clearly written chapters is accompanied by a wealth of line drawings and photographs that demonstrate both the surgical and non-surgical approaches to examination and treatment.
In this new volume, Dr. Gregory Fanelli, of the Geisinger Medical Center and a reknowned expert on knee injuries, provides orthopaedic surgeons with an unprecedented review of the most recent and advanced knowledge needed to successfully diagnosis and treat PCL injuries. This comprehensive and practical volume covers everything from biomechanics and anatomy, evaluation and non-operative treatment to the latest surgical treatments of PCL injuries using arthroscopy, grafts and synthetic ligament substitutes. In addition, contributions from such well-known specialists as Drs. M. Malek, Roger Larson and Fred Flandery make this an essential text for every orthopaedic surgeon.
Background: Anterior cruciate ligament (ACL) injury is a severe and common injury, and females have 2-4 times higher injury risk compared to men. Return to sport (RTS) is a common goal after an ACL reconstruction (ACLR), but only about two thirds of patients RTS. Young patients who RTS may have a 30-40 times increased risk of sustaining an additional ACL injury to the ipsi- or contralateral knee compared with an uninjured person. Aims: The overall aim of this thesis was to increase the knowledge about female football players with ACLR, and patients with bilateral ACL injuries, and to identify predictors for additional ipsi- and/or contralateral ACLR. Methods: This thesis comprises four studies. Study I and II were cross-sectional, including females who sustained a primary ACL rupture while playing football and underwent ACLR 6–36 months prior to study inclusion. In study I, 182 females were included at a median of 18 months (IQR 13) after ACLR. All players completed a battery of questionnaires. Ninety-four players (52%) returned to football and were playing at the time of completing the questionnaires, and 88 (48%) had not returned. In study II, 77 of the 94 active female football players (from study I) with an ACLR and 77 kneehealthy female football players were included. A battery of tests was used to assess postural control (the Star excursion balance test) and hop performance (the one-leg hop for distance, the five jump test and the side hop). Movement asymmetries in the lower limbs and trunk were assessed with the drop vertical jump and the tuck jump using two-dimensional analyses. Study III, was a cohort study including all patients with a primary ACLR (n=22,429) registered in the Swedish national ACL register between January 2005 and February 2013. Data extracted from the register to identify predictors for additional ACLR were: patient age at primary ACLR, sex, activity performed at the time of ACL injury, primary injury to the right- or left knee, time between injury and primary ACLR, presence of any concomitant injuries, graft type, Knee injury and Osteoarthritis Outcome Score and Euroqol Index Five Dimensions measured pre-operatively. Study IV was cross-sectional. In this study, patient-reported knee function, quality of life and activity level in 66 patients with bilateral ACL injuries was investigated and outcomes were compared with 182 patients with unilateral ACLR. Results: Factors associated with returning to football in females were; short time between injury and ACLR (0–3 months, OR 5.6; 3–12 months OR 4.7 vs. reference group >12 months) and high motivation (study I). In all functional tests, the reconstructed and uninvolved limbs did not differ, and players with ACLR and controls differed only minimally. Nine to 49% of the players with ACLR and controls had side-to-side differences and movement asymmetries and only one fifth had results that met the recommended guidelines for successful outcome on all the different tests (study II). Main predictors for revision and contralateral ACLR were younger age (fourfold increased rate for <16 vs. >35-year-old patients), having ACLR early after the primary injury (two to threefold increased rate for ACLR within 3 months vs. >12 months), and incurring the primary injury while playing football (study III). Patients with bilateral ACL injuries reported poorer knee function and quality of life compared to those who had undergone unilateral ACLR. They had a high activity level before their first and second ACL injuries but an impaired activity level at follow-up after their second injury (study IV). Conclusions: Female football players who returned to football after an ACLR had high motivation and had undergone ACLR within one year after injury. Players with ACLR had similar functional performance to healthy controls. Movement asymmetries, which in previous studies have been associated with increased risk for primary and secondary ACL injury, occurred to a high degree in both groups. The rate of additional ACLR seemed to be increased in a selected group of young patients who desire to return to strenuous sports like football quickly after primary ACLR. Sustaining a contralateral ACL injury led to impaired knee function and activity level.
Knee ligament injuries are very common and are frequently sports related, although they may arise from trauma experienced during everyday activities. This book provides in-depth descriptions of the extra articular surgical techniques that may be employed when performing ligament reconstruction in patients with injuries involving the posterolateral and posteromedial corners of the knee. It is intended as a practical, “how to” manual that will be of value for both the trainee and the more experienced surgeon. Many of the techniques relate to the central pivot of the knee, i.e. the anterior and posterior cruciate ligaments. For each technique, indications, presurgical planning, postsurgical follow-up and complications are discussed in addition to the surgical details. Numerous tips and pearls are provided and the techniques are clearly depicted in informative high-quality illustrations.
Diagnosis and Treatment of Ligamentous Injuries about the Knee
Author: John A. Feagin
A revised and updated practical guide (1st ed., 1988) for both students and experienced knee surgeons. The case studies in Section I present an algorithm for the management of specific problems associated with the crucial ligaments. The pages preceding the first case study, titled "Principles of Diagnosis and Treatment," apply to all the case studies, and emphasize the fundamentals of good knee care. Following the 21 case studies (now including a whole subsection of sequelae case studies) are eight sections that support the case studies: history, evolution, epidemiology; anatomy, kinematics; diagnosis; natural history, prevention, counseling; surgical treatment; sequelae; rehabilitation; and prosthetic ligaments. Annotation copyright by Book News, Inc., Portland, OR
Master the very latest clinical and technical information on the full range of anterior cruciate ligament reconstruction techniques. Both inside the remarkably user-friendly printed version of this Expert Consult title and on its fully searchable web site, you'll find detailed coverage of hamstring, allograft and bone-tendon-bone (BTB) ACL reconstruction (including single versus double bundle techniques), and hamstring graft harvesting; plus fixation devices, rehabilitation, revision ACLR surgery, and much more! A "dream team" of ACL surgeons provides the advanced guidance you need to overcome the toughest challenges in this area. A comparison of the full range of graft options for ACL reconstruction makes it easier to choose the best approach for each patient. State-of-the-art information on the latest principles and technical considerations helps you avoid complications. ‘How to' principles of post-op rehabilitation and revision ACL surgery optimize patient outcome. Access to the full contents of the book online enables you to consult it from any computer and perform rapid searches. Also available in an upgradeable premium online version including fully searchable text PLUS timely updates.
Covers the expansion in knee treatment options with the methods for diagnosis, treatment, and reconstruction of the knee. This book also offers evaluation and testing techniques, relevant anatomy and biomechanics, and extended discussion of rehabilitative methods and possible complications.
Considers the conservative and post-surgical rehabilitation of the knee meniscus, MCL, ACL and PCL. It discusses the fundamentals of examination, diagnosis, rehabilitation, conservative management, biomechanics and biomaterials and details the rehabilitation of each ligament.
A text devoted to knee rehabilitation with chapters contributed by rehabilitation specialists on the management of specific knee pathologies or injuries. The volume is based on the physical therapy model of treatment: making a physical therapy problem list, determining the characteristics and factors that affect the problems, setting goals of treatment, making a treatment plan for reaching those goals, and reevaluating and modifying the treatment. For both practicing clinicians and physical therapy students. Annotation copyright by Book News, Inc., Portland, OR