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At least 19 recordsLinked to original sources

PubMed2026

Primary ACL Repair and Reconstruction in Isolated ACL Ruptures: Forgotten Joint Scores and the Association Between Residual Laxity and Joint Awareness.

BACKGROUND: Primary anterior cruciate ligament (ACL) repair has recently reemerged as a treatment option for carefully selected proximal ACL tears. However, evidence regarding patient-reported joint awareness and the relationship between postoperative laxity and joint awareness remains limited. PURPOSE: To compare joint awareness, clinical outcomes, and postoperative laxity between primary ACL repair and hamstring tendon autograft reconstruction in carefully selected patients with isolated ACL rupture, and to explore the association between residual laxity and postoperative joint awareness. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This retrospective cohort study included 85 patients with isolated ACL rupture treated with either primary ACL repair (n = 26) or hamstring autograft reconstruction (n = 59), with a minimum follow-up of 24 months. Clinical outcomes, including visual analog scale score, Lysholm score, International Knee Documentation Committee (IKDC) score, Tegner activity scale score, postoperative knee laxity, return to sport, and rerupture rates, were evaluated. The authors also used the Forgotten Joint Score-12 (FJS-12), a measure of joint awareness, to evaluate patients. A higher score reflects lower joint awareness, suggesting function more similar to a native knee. Multivariable regression analyses were performed to evaluate variables associated with postoperative FJS-12 values. RESULTS: No differences were observed between groups in postoperative Lysholm, IKDC, and Tegner activity scale scores; Lachman- and pivot-shift-assessed postoperative laxity; and return-to-sport rates. However, postoperative FJS-12 values were significantly higher in the repair group compared with the reconstruction group (87.0 ± 15.0 vs 77.5 ± 14.2; mean difference, 9.5 points [95% CI, 2.8-16.3]; P = .006), corresponding to a moderate effect size (Cohen d = 0.66). Secondary exploratory regression analyses demonstrated that residual postoperative laxity was associated with lower postoperative FJS-12 values in both Lachman- and pivot-shift-based models (R2 = 0.649 and 0.680, respectively; P < .001 for both). CONCLUSION: In carefully selected patients with proximal ACL tears and adequate tissue quality, no significant between-group differences were detected in conventional clinical outcomes, postoperative laxity, return-to-sport rates, or rerupture rates between primary ACL repair and reconstruction. Primary ACL repair was associated with higher postoperative FJS-12 values at short- to midterm follow-up, suggesting function more similar to that of a native knee. Residual postoperative laxity was associated with lower FJS-12 values in secondary exploratory analyses.

Humans↗

PubMed2026

Outcomes of Suture Tape-Augmented ACL Reconstruction in Patients With High Internal Rotational Tibial Subluxation: A Minimum 3-Year Cohort Study.

BACKGROUND: Anterior cruciate ligament reconstruction (ACLR) using hamstring tendon (HT) autografts faces persistent challenges of graft failure, especially in patients with high internal rotational tibial subluxation (IRTS). HYPOTHESIS: Patients with high IRTS who undergo HT autograft ACLR with suture tape augmentation (STA) will have lower graft failure rates and superior clinical outcomes as compared with those without STA. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: This retrospective cohort study included patients with high IRTS-defined as lateral minus medial anterior tibial subluxation >5.8 mm based on prior studies-who underwent primary ACLR using HT autografts with STA and had a minimum follow-up of 3 years. Propensity score matching (1:1) was performed to identify a control group of patients with similarly high IRTS who underwent HT ACLR without STA. Postoperative outcomes were assessed by the International Knee Documentation Committee score, Lysholm score, and Tegner activity scale, as well as by return-to-sport status and graft failure. Clinically meaningful improvements were evaluated by the minimal clinically important difference, Patient Acceptable Symptom State, and substantial clinical benefit. RESULTS: This study included 62 patients with high IRTS: 31 with STA and 31 matched controls. The mean IRTS was 6.6 mm (range, 5.9-8.9) in the STA group and 6.8 mm (range, 5.8-8.7) in the control group. The mean patient age was 32.9 years (range, 20-50), and the mean follow-up was 3.8 years (range, 3.1-5.0). At final follow-up, the STA group showed significantly higher proportions of patients achieving the minimal clinically important difference (93.5% vs 74.2%; P = .038), Patient Acceptable Symptom State (96.8% vs 74.2%; P = .012), and substantial clinical benefit (54.8% vs 25.8%; P = .020). The return-to-sport rate was also higher in the STA group (74.2% vs 48.4%; P = .037). Additionally, the STA group demonstrated a lower graft failure rate (0% vs 12.9%; P = .039). CONCLUSION: For patients with high IRTS, STA in ACLR with HT autografts is associated with improved clinical outcomes, a higher return-to-sport rate, and a lower risk of graft failure at midterm follow-up.

Humans↗

PubMed2026

Application of musculoskeletal ultrasound in postoperative rehabilitation assessment and monitoring after rotator cuff repair: A systematic review.

BACKGROUND: The development of rehabilitation protocols after rotator cuff repair has long lacked objective benchmarks. Traditional time‑based regimens are limited by considerable inter‑individual variability and an increased risk of re‑tear. Musculoskeletal ultrasound allows dynamic assessment of tendon healing and muscle morphology, yet evidence for directly linking its use to rehabilitation decisions remains scarce. OBJECTIVE: To systematically synthesize the evidence on the use of musculoskeletal ultrasound monitoring to inform rehabilitation decision‑making after rotator cuff repair. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses (PRISMA) guidelines, we searched PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data from January 2020 to April 2026. Original studies were included if they involved patients who had undergone rotator cuff repair, used musculoskeletal ultrasound (including gray‑scale ultrasound, elastography, etc.) to evaluate the rotator cuff tendons or shoulder muscles, and reported at least one parameter related to rehabilitation decision-making or functional outcomes. RESULTS: Eleven studies were included. Shear wave velocity (SWV), cross‑sectional area (CSA), and echo intensity (EI) were the most frequently reported ultrasound parameters. Available evidence indicated that SWV increased progressively after surgery, with an overall increase of approximately 22% to 25% from one week to 12 months postoperatively. This dynamic trajectory may serve as a reference baseline for judging rehabilitation progress. An abnormally elevated SWV in the early postoperative period was associated with an increased risk of re‑tear, suggesting that a more conservative rehabilitation strategy should be adopted. Tendon stiffness measured at 12 weeks after surgery independently predicted long‑term return to sport. Regarding muscle parameters, changes in CSA and EI were positively correlated with shoulder function scores, and the combination of these two parameters effectively identified patients with rehabilitation bottlenecks. CONCLUSION: Musculoskeletal ultrasound parameters are associated with the initiation of active movement, adjustment of exercise load, prediction of return‑to‑sport prognosis, and identification of retear risk. Among these, SWV shows particular promise as an objective monitoring parameter for supporting rehabilitation assessment after rotator cuff repair. Future randomized controlled trials are needed to determine whether ultrasound-informed assessment can improve rehabilitation outcomes compared with traditional time-based regimens, and to establish standardized measurement protocols and clinically applicable reference values. Key findings of this review are summarized in S1 File.

Humans↗

PubMed1975

[Chronic knee instability. Technics and results of ligament plasty in sports injuries].

Chronic laxity of the knee in sportsmen is limited in practice, owing to the mechanisms of blockage of rotation, to lesions of the medial and anterior cruciate ligaments, associated or not with tears of the meniscus. Full assessment is essential to draw up a full therapeutic plan. It is very difficult, even when clinical examination is completed by excellent XRays. The great technical facility of operations of musculo-aponeurotic transposition, has led surgeons to discard plastic operations on the ligaments. They do, however, give the best chance of return to sporting activity. Two techniques are discussed, one a plastic of the medial ligament, the other designed to palliate rupture of the anterior cruciate ligament. These operations are strong and precise straightaway but the prognosis depends mainly on the number of structures affected.

Athletic Injuries↗

PubMedDate not supplied

Cylinder or mobile cast brace after knee ligament surgery. A clinical analysis and morphologic and enzymatic studies of changes in the quadriceps muscle.

Sixteen patients participated in a prospective randomized trial in which a standard cylinder cast was compared with a mobile cast brace. Both were worn for 4 weeks, beginning at 1 week after reconstruction of the anterior cruciate ligament. The athletes that had used a cast brace could return to sports activities in about one-half the time it took for the athletes with a standard cast. The patients with a standard cast showed a significant atrophy of Type I (slow twitch) muscle fibers in the vastus lateralis. The cast brace patients did not show any significant changes in cross-sectional areas of Type I or Type II (fast twitch) muscle fibers. The standard cast patients had a significant reduction of succinate dehydrogenase (SDH) activity in the vastus lateralis whereas the patients with the cast brace did not show any significant changes. No difference in surgical end result was found. A cast brace with a limited range of motion between 20 and 60 degrees of flexion is recommended as the standard postoperative treatment after knee ligament surgery.

Adult↗

PubMed1978

Anterior cruciate ligament repair for rotatory instability: the Lindemann dynamic muscle-transfer procedure.

The Lindemann operation, originally performed in 1950 as a reconstructive procedure for the anterior cruciate ligament, was performed in the knees of eight patients suffering from rotatory instability. Although the instability persisted, as shown by roentgenographic and clinical examination, treatment with the tendon transfer appears to have provided dynamic stabilization. Seven of the eight patients so treated were subjectively improved, and they returned to sports or activities which they had not been able to perform prior to surgery.

Adult↗

PubMed1977

["Chronic inguinal strain" in top-athletes and its treatment (author's transl)].

The picture of "chronic inguinal strain" must be regarded as a further development of the "gracilis-syndrome" described by Schneider in 1964 (posttraumatic pibic osteonecrosis). These are rupture of the tendons of gracilis and adductor-longus, degenerated at their points of insertion on the pubic bone. Only surgery is successful. As described by Schneider, the tendon is divided and osteonecrotic tissue removed. If there is rupture the necrotic part of the tendon is excised, the remainder suture red to the nearby tendon. Re-fixation of the tendon at the pubic bone is unnecessary because of the very monor adduction-function of gracilis. Return to sport will be possible-on average-after 6-8 weeks.

Adult↗

PubMedDate not supplied

Primary internal fixation of carpal navicular fractures in the athlete.

Primary open reduction and internal fixation is an established procedure for treatment of carpal navicular fractures. With the use of an alignment device, the surgery can be performed on outpatients, under local anesthesia, in 30 to 45 min. The wrist is splinted in a protective device for approximately 6 weeks but no cast is necessary. Four of 13 patients in this series have been athletes. The procedure has allowed them to participate in sports during the healing period and to return to contact sports 6 to 8 weeks postoperatively without joint protection. These athletes have regained full range of motion in the wrist joint. Although the procedure is not recommended for hairline fractures which usually heal quickly or comminuted fractures of the navicular, it appears to be the treatment of choice for fractures of the carpal navicular bone at the level of the middle and proximal third of the bone or any displaced fragment with malposition in the axial or rotary plane.

Athletic Injuries↗

PubMed2026

Preoperative Proximal Migration of the Radial Head as an Independent Predictor of Suboptimal Outcomes After Osteochondral Autograft Transplantation for Capitellar Osteochondritis Dissecans: A Retrospective Cohort Study.

BACKGROUND: Osteochondral autograft transplantation (OAT) is widely performed for capitellar osteochondritis dissecans (OCD). However, preoperative predictors of suboptimal postoperative outcomes remain unclear. PURPOSE/HYPOTHESIS: The authors aimed to evaluate clinical outcomes after OAT for capitellar OCD and identify preoperative risk factors associated with suboptimal outcomes. They hypothesized that radiographic indicators of disease severity, including preoperative proximal migration of the radial head, lesion size, and lateral wall disruption, would be associated with suboptimal postoperative clinical outcomes. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: The records of adolescent athletes who underwent OAT for capitellar OCD with a minimum 2-year follow-up were retrospectively reviewed. Clinical outcomes included elbow range of motion (ROM) and Timmerman-Andrews (T-A) score. A suboptimal outcome was defined as a postoperative T-A score <160. Preoperative radiographs were used to measure proximal migration of the radial head relative to the coronoid process, hypertrophy of the radial head, OCD lesion area, and a 5-grade lateral wall disruption classification; measurement reliability was assessed. Multivariate logistic regression analysis was performed to identify independent predictors of a suboptimal outcome, and receiver operating characteristic (ROC) curve analysis was used to determine the optimal cutoff value for proximal migration. RESULTS: A total of 69 elbows (mean age, 13.6 years; mean follow-up, 48 months) were included. ROM and T-A scores improved significantly after OAT, and all athletes returned to any sports. Of these, 50 elbows (72%) achieved good outcomes, whereas 19 (28%) had suboptimal outcomes. Preoperative proximal migration was significantly greater in the suboptimal outcome group compared with the good outcome group (mean, 2.1 ± 2.3 vs 0.5 ± 1.7 mm; P = .002), as were lesion area (mean, 70 ± 16 vs 58 ± 20 mm2; P = .02) and lateral wall disruption grade (median, 5 vs 3; P = .01). On multivariate analysis, proximal migration of the radial head was the only independent predictor of a suboptimal outcome (adjusted OR, 1.47 per 1-mm increase; 95% CI, 1.03-2.09; P = .033). ROC analysis showed an area under the curve of 0.72 with an optimal cutoff of 2.2 mm (sensitivity, 56%; specificity, 84%). CONCLUSION: OAT resulted in significant clinical improvement in adolescents with capitellar OCD; however, 28% of patients were classified as having suboptimal outcomes. Preoperative proximal migration of the radial head is an independent predictor of a suboptimal postoperative outcome. A value >2.2 mm may indicate advanced radiocapitellar incongruity, a condition in which OAT may be less effective.

Humans↗

PubMed1979

Chronic dislocation of the sternoclavicular joint: an operative repair.

Chronic spontaneous dislocation of the sternoclavicular joint occurs more frequently in athletes than nonathletes, causing weakness and sometimes pain during prolonged stress upon the arm. Five such joints were successfully treated in 4 patients by means of a dynamic method of repair--tenodesis of the sternal head of the sternomastoid muscle. The sternal origin of the sternomastoid muscle in continuity with its muscle belly and strip of sternal periosteum is looped under the first rib, back through a drill hole in the clavicle and sutured to itself to replace the damaged costoclavicular ligament. Dislocations of the joint should not be repaired for purely cosmetic reasons as the risk of keloid scar formation in this region is notoriously high. All the patients who were young and athletically inclined, recovered fully within 4 months of the operation and returned to their sporting activities. Follow-up has ranged from 12 to 38 months. There have been no late complications or failures of the technique.

Adolescent↗

PubMedDate not supplied

Hand and wrist injuries in the athlete.

Injuries to the hand and wrist are probably among the most common injuries incurred by the athlete. Neglect of such injuries may result in irreparable damage to the hand or wrist. This summary of the more common injuries to these areas seen in the athlete, with a description of the recognition and treatment, gives the reader insight into the multiple considerations the athlete and coach must have. Even seemingly minor injuries must be carefully evaluated and treated by a physician. Early diagnosis, accurate precise treatment, and proper rehabilitation are extremely important to regain optimal function after these injuries. They may have a significant impact not only in athletic competition but also in the athlete's selection of an occupation. It is psychologically important also that the participant be returned to his particular sport as soon as possible. Most of the injuries can be controlled by conservative means. However, when surgical repair is indicated, it is important for the surgeon to be trained and familiar with the anatomy and techniques of surgery of the hand and wrist.

Athletic Injuries↗

PubMedDate not supplied

Surgical treatment of partial Achilles tendon rupture.

Fifty-four patients with a total of 58 partial ruptures of the Achilles tendon were treated surgically. The postoperative observation time ranged from 8 months to 7 years. Forty-six patients indicated that they were pleased with the results, 8 were satisfied, and 3 were unsatisfied (one died during the interim). Thirty-seven of the 44 patients who had been engaged in competitive sports preoperatively were able to return successfully to the activity. We recommend surgical treatment if conservative treatment for presumed tendinitis is not successful. The operative procedure may encourage revascularization to the Achilles tendon and innervation after surgical excision of the pathologic and degenerated tissue.

Achilles Tendon↗

PubMedDate not supplied

Extra-articular reconstructive surgery for combined anterolateral-anteromedial rotatory instability.

The knees of 14 patients (12 male and 2 female) were treated surgically by extra-articular reconstruction for combined anterolateral-anteromedial rotatory instability. Healing and rehabilitation required approximately 8 months after the operations. Only after adequate rehabilitation, including return of full confidence, were the patients released to full activity (although contact sports are not recommended). Of the group, 12 patients returned for follow-up evaluations and one returned a questionnaire. One patient was lost to follow-up. One patient did not return to full activity because in the 3rd month postoperatively, he stepped in a hole while jogging, reinjured his knee, and refused further surgery. The functional improvement in this series by our extra-articular procedure (a combination of an anteromedial capsulorrhaphy and pes transfer medially with Ellison's modification of an iliotibial band rerouting and partial biceps advancement laterally) compares favorably with the reported anterior cruciate ligament reconstructions. Further comparisons with longer periods of time after surgical procedures are needed to determine whether extra-articular repair with interarticular reconstruction of the anterior cruciate ligament is significantly better than this technically easier extra-articular repair alone.

Adolescent↗

PubMed1978

Chronic overuse injuries of the piso-triquetral joint in racquet game players.

Three squash racquets and one badminton player presented with pain in the base of the hypothenar eminence, due to minor degrees of subluxation of the pisiform bone. Two of them also showed chondromalacia of the articular cartilage of the pisotriquetral joint. All four patients were relieved by excision of the pisiform bone and had returned to their normal daily and sporting activities within three months of their operation.

Adolescent↗

PubMedDate not supplied

The Cybex II evaluation of surgically repaired Achilles tendon ruptures.

Thirty-two patients with 33 complete ruptures of the Achilles tendon with surgical repair were evaluated with the Cybex II isokinetic unit. The evaluations were performed from 6 to 144 months postoperatively. The repaired Achilles tendon had a 16.5% loss of plantarflexion strength and a 17.5% loss of plantarflexion power. The early repairs had a smaller loss of strength and power than late repairs. Twenty-seven of the patients returned to their former level of sports activity.

Achilles Tendon↗

PubMed1979

Tennis elbow. The surgical treatment of lateral epicondylitis.

Of the 1,213 clinical cases of lateral tennis elbow seen during the time period from December 19, 1971, to October 31, 1977, eighty-eight elbows in eighty-two patients had operative treatment. The lesion that was consistently identified at surgery was immature fibroblastic and vascular infiltration of the origin of the extensor carpi radialis brevis. A specific surgical technique was employed, including exposure of the extensor carpi radialis brevis, excision of the identified lesion, and repair. The results at follow-up were rated as excellent in sixty-six elbows, good in nine, fair in eleven, and failed in two. There was an over-all improvement rate of 97.7 per cent, and 85.2 per cent of the patients returned to full activity including rigorous sports.

Adult↗

PubMed1976

Late reconstruction of the ligaments following acromioclavicular separation.

Complete separation of the acromion from the clavicle in nine young patients was repaired by a new technique with use of a tendon graft. The operation was performed, on average, twenty-nine weeks after the injury. After surgery seven patients were enabled to engage in strenuous sports or construction work and the other two to return to daily activities with occasional heavy lifting.

Acromioclavicular Joint↗

PubMed1976

[Surgical treatment of knee joint ligaments].

Because injuries of the ligaments of the knee joint, during 11 years 58 operations have been performed by the authors. In order to evaluate the late results, all patients have been reexamined 1 to 10 years after the operation. In more than the half of the cases at the least 2 ligament injuries have been operated on. 31 patients underwent the operation within two weeks after the injury, and the other patients later on. The authors' material and results are compared also with the data of the literature. In the authors' opinion the result of the surgical treatment is not decisively depending on the chosen operative method. The early and exact diagnosis--forming the basis of the suitable treatment--are of far greater importance. The perfect operative technique and the consequent rehabilitation are indispensable requirements of all surgical interventions. After severe ligament injury of the knee joint the surgical intervention allowed to 2/3 or 3/4 of the injured patients to return to work with stabilized knee. In younger patients also sporting may be possible. Therefore the surgical treatment of the knees, which became unstable because of ligament injury, is absolutely indicated in patients in working age.

Humans↗