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[PMID]:28749699
[Au] Autor:Herrington L; Alarifi S; Jones R
[Ad] Endereço:Centre for Health, Sport and Rehabilitation Sciences, University of Salford, Salford, UK.
[Ti] Título:Patellofemoral Joint Loads During Running at the Time of Return to Sport in Elite Athletes With ACL Reconstruction.
[So] Source:Am J Sports Med;45(12):2812-2816, 2017 Oct.
[Is] ISSN:1552-3365
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Patellofemoral joint pain and degeneration are common in patients who undergo anterior cruciate ligament reconstruction (ACLR). The presence of patellofemoral joint pain significantly affects the patient's ability to continue sport participation and may even affect participation in activities of daily living. The mechanisms behind patellofemoral joint pain and degeneration are unclear, but previous research has identified altered patellofemoral joint loading in individuals with patellofemoral joint pain when running. It is unclear whether this process occurs after ACLR. PURPOSE: To assess the patellofemoral joint stresses during running in ACLR knees and compare the findings to the noninjured knee and matched control knees. STUDY DESIGN: Controlled laboratory study. METHODS: Thirty-four elite sports practitioners who had undergone ACLR and 34 age- and sex-matched controls participated in the study. The participants' running gait was assessed via 3D motion capture, and knee loads and forces were calculated by use of inverse dynamics. RESULTS: A significance difference was found in knee extensor moment, knee flexion angles, patellofemoral contact force (about 23% greater), and patellofemoral contact pressure (about 27% greater) between the ACLR and the noninjured limb ( P ≤ .04) and between the ACLR and the control limb ( P ≤ .04); no significant differences were found between the noninjured and control limbs ( P ≥ .44). CONCLUSION: Significantly greater levels of patellofemoral joint stress and load were found in the ACLR knee compared with the noninjured and control knees. CLINICAL RELEVANCE: Altered levels of patellofemoral stress in the ACLR knee during running may predispose individuals to patellofemoral joint pain.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/fisiopatologia
Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior
Artralgia/fisiopatologia
Articulação Patelofemoral/fisiopatologia
Volta ao Esporte
[Mh] Termos MeSH secundário: Atividades Cotidianas
Adulto
Fenômenos Biomecânicos
Feminino
Marcha/fisiologia
Seres Humanos
Masculino
Articulação Patelofemoral/fisiologia
Corrida/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170728
[St] Status:MEDLINE
[do] DOI:10.1177/0363546517716632


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[PMID]:29351558
[Au] Autor:Costa LA; Foni NO; Antonioli E; Teixeira de Carvalho R; Paião ID; Lenza M; Ferretti M
[Ad] Endereço:Hospital Israelita Albert Einstein, São Paulo, São Paulo, Brazil.
[Ti] Título:Analysis of 500 anterior cruciate ligament reconstructions from a private institutional register.
[So] Source:PLoS One;13(1):e0191414, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The aims of this study are to describe the epidemiological characteristics of anterior cruciate ligament reconstructions in a private hospital in Brazil and to determine trends in medical practice for comparison with previous studies. METHODS: We retrospectively reviewed the anterior cruciate ligament institutional register to obtain data from all patients who underwent primary anterior cruciate ligament reconstruction from July 2014 to June 2016. Descriptive statistics were used to summarize the sample. Specific statistical tests were used to assess associations between the meniscal lesion and other variables. RESULTS: During the study period, 72.6% out of 500 patients were male. The mean age at surgery was 35.1 years. The mean age was higher among females than among males (37.3 ± 12.1 vs 34.3 ± 10.8 years). The median time from injury to surgery was 44 days. The most common femoral and tibial fixations used were suspensory fixation (60.8%) and interference screw (96%), respectively. The most commonly used graft was hamstring tendon (70.2%), followed by bone-patellar tendon-bone (28.8%). A meniscal lesion was noted in 44.8% of cases. Partial meniscectomy was performed in 69.5% of meniscal lesions, and meniscal repair was performed in 14.1% of lesions. The mean length of hospital stay was 1.4 days. The proportion of men in the group of patients with an associated meniscal lesion was higher than that in the group of patients without a meniscal lesion (p = 0.007). CONCLUSIONS: In this study, we identified that the vast majority of surgeries were performed in male patients in all age groups, and patients older than 30 years and with a short time from injury to surgery predominated. Concerning surgical technique, we noted a low rate of meniscal repair and a higher preference for the use of hamstring graft and suspensory fixation on the femoral side.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior
[Mh] Termos MeSH secundário: Adulto
Reconstrução do Ligamento Cruzado Anterior/métodos
Reconstrução do Ligamento Cruzado Anterior/estatística & dados numéricos
Brasil
Feminino
Seres Humanos
Masculino
Meia-Idade
Sistema de Registros
Estudos Retrospectivos
Fatores Sexuais
Lesões do Menisco Tibial/cirurgia
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180305
[Lr] Data última revisão:
180305
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191414


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[PMID]:29279562
[Au] Autor:Oshima Y; Iizawa N; Takai S
[Ad] Endereço:Department of Orthopaedic Surgery, Nippon Medical School.
[Ti] Título:Midterm Result of Arthroscopic Bicruciate Ligament Sutures for Multiligament Knee Injury in an Adolescent Patient.
[So] Source:J Nippon Med Sch;84(6):301-303, 2017.
[Is] ISSN:1347-3409
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Treatment of multiligament knee injuries, especially in adolescent patients, is challenging for orthopedic surgeons. Repair of collateral ligaments and reconstruction of cruciate ligaments are usually performed, however, ligament reconstruction with transphyseal or physeal-sparing techniques may lead to physeal damage and growth disturbances in skeletally immature patients. We present a case report on performing bicruciate ligament sutures arthroscopically in an adolescent patient. PATIENT AND METHODS: The patient was a 14-year-old boy, who was diagnosed with injuries to the anterior cruciate ligament, posterior cruciate ligament, and medial collateral ligament. Single-stage arthroscopic primary suturing of the anterior and posterior cruciate ligaments and open medial collateral ligament suturing were performed 7 days after the injury. RESULTS AND DISCUSSION: The patient returned to routine activities, including high-level competitive sports, at 8 months post-surgery, and currently, 8.5 years after surgery, remains without complications. Suture repair was able to minimize the size of the bone tunnels and to re-establish knee stability with native tissues. Therefore, the application of sutures may be a useful option for repairing multiligament knee injuries, particularly in adolescent patients.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/cirurgia
Ligamento Cruzado Anterior/cirurgia
Artroscopia/métodos
Ligamentos Colaterais/lesões
Ligamentos Colaterais/cirurgia
Traumatismos do Joelho/cirurgia
Ligamento Colateral Médio do Joelho/lesões
Ligamento Colateral Médio do Joelho/cirurgia
Procedimentos Ortopédicos/métodos
Ligamento Cruzado Posterior/lesões
Ligamento Cruzado Posterior/cirurgia
Procedimentos Cirúrgicos Reconstrutivos/métodos
Técnicas de Sutura
[Mh] Termos MeSH secundário: Adolescente
Seres Humanos
Masculino
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171228
[St] Status:MEDLINE
[do] DOI:10.1272/jnms.84.301


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[PMID]:29304118
[Au] Autor:Nagano Y; Yako-Suketomo H; Natsui H
[Ad] Endereço:Department of Sports Wellness Sciences, Japan Women's College of Physical Education, Tokyo, Japan.
[Ti] Título:Anterior cruciate ligament injury: Identifying information sources and risk factor awareness among the general population.
[So] Source:PLoS One;13(1):e0190397, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Raising awareness on a disorder is important for its prevention and for promoting public health. However, for sports injuries like the anterior cruciate ligament (ACL) injury no studies have investigated the awareness on risk factors for injury and possible preventative measures in the general population. The sources of information among the population are also unclear. The purpose of the present study was to identify these aspects of public awareness about the ACL injury. MATERIALS AND METHODS: A questionnaire was randomly distributed among the general population registered with a web based questionnaire supplier, to recruit 900 participants who were aware about the ACL injury. The questionnaire consisted of two parts: Question 1 asked them about their sources of information regarding the ACL injury; Question 2 asked them about the risk factors for ACL injury. Multivariate logistic regression was used to determine the information sources that provide a good understanding of the risk factors. RESULTS AND DISCUSSION: The leading source of information for ACL injury was television (57.0%). However, the results of logistic regression analysis revealed that television was not an effective medium to create awareness about the risk factors, among the general population. Instead "Lecture by a coach", "Classroom session on Health", and "Newspaper" were significantly more effective in creating a good awareness of the risk factors (p < 0.001).
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/epidemiologia
Conscientização
[Mh] Termos MeSH secundário: Adulto
Estudos Transversais
Feminino
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180106
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190397


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[PMID]:28466182
[Au] Autor:Domnick C; Garcia P; Raschke MJ; Glasbrenner J; Lodde G; Fink C; Herbort M
[Ad] Endereço:Department of Trauma-, Hand- and Reconstructive Surgery, Westphalian Wilhelms University Muenster, Waldeyer Strasse 1, 48149, Muenster, Germany.
[Ti] Título:Trends and incidences of ligament-surgeries and osteotomies of the knee: an analysis of German inpatient records 2005-2013.
[So] Source:Arch Orthop Trauma Surg;137(7):989-995, 2017 Jul.
[Is] ISSN:1434-3916
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: In Germany most surgical procedures of the ligaments of the knee and correcting osteotomies of the knees are performed within an inpatient setting. The purpose of this study was to analyze the available data to assess epidemiological trends and incidences in inpatient knee joint surgery. MATERIALS AND METHODS: Approximately 154 million anonymized DRG inpatient records were collected by the German Federal Statistical Office between 2005 and 2013. These data were screened and analyzed for knee joint surgical ligamental procedures and osteotomies. RESULTS: Anterior cruciate ligament reconstruction (ACLR) or repair had a high incidence (46 per 100,000 persons/year). In addition, the most frequent grafts included hamstring tendon (90%) and the patellar tendon (6.3%) autografts (2013). Peak age group for ACLR was 15-20 years (14.5%) for female and 20-25 years (23.6%) for male patients, while there was a second peak in the age group 45-50 years (13.8%) for female patients. Male patients had a higher risk for receiving ACLR (RR 1.96; 95% CI 1.92-2.00) and for receiving valgizing high tibial osteotomy (RR 2.43; 95% CI 2.27-2.61). Females had a higher risk for receiving varizing distal femur osteotomy (RR 1.89; 95% CI 1.58-2.26). CONCLUSION: There are growing trends for joint- and activity-preserving procedure in the middle-aged patients. The knowledge of the trends and incidences related to these procedures may help to validate and discuss the results of clinical and register studies.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/epidemiologia
Reconstrução do Ligamento Cruzado Anterior/estatística & dados numéricos
[Mh] Termos MeSH secundário: Adolescente
Adulto
Fatores Etários
Ligamento Cruzado Anterior/cirurgia
Lesões do Ligamento Cruzado Anterior/etiologia
Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior/métodos
Criança
Feminino
Alemanha/epidemiologia
Seres Humanos
Incidência
Pacientes Internados
Masculino
Meia-Idade
Sistema de Registros
Fatores Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1007/s00402-017-2704-0


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[PMID]:29314794
[Ti] Título:Isokinetic profile of subjects with the ruptured anterior cruciated ligament.
[So] Source:Vojnosanit Pregl;73(7):631-5, 2016 Jul.
[Is] ISSN:0042-8450
[Cp] País de publicação:Serbia
[La] Idioma:eng
[Ab] Resumo:Background/Aim: All changes in the knee that appear after anterior cruciate ligament (ACL) lesion lead to difficulties in walking, running, jumping especially during sudden changes of the line of movement. This significantly impairs quality of life of these subjects and leads to decrease in physical activity. Knee injuries make 5% of all most severe acute sport injuries. The aim of the study was to determine strength of the thigh muscles in persons with unilateral rupture of the ACL and to evaluate potential bilateral differences between healthy and injured leg. Methods: This study involved 114 male athletes of different sport specialities with the clinical diagnosis of ACL rupture. Each subject had unilateral ACL rupture and the other leg was actually the control for this research. An isokinetic device was used to evaluate the muscle strength of thigh muscles. Testing was performed for two testing speeds, 60º/s and 180º/s. Results: Data analysis showed a statistically significant difference (p < 0.01) between the ACL and the healthy leg in the following parameters: peak torque for thigh extensors (Ptrq_E), angle to peak torque during extension (Ang_E), power of extension (Pow_E) and work during extension (Work_E). Analysing hamstrings to quadriceps (H/Q) ratio we found the unilateral disbalance of thigh muscle strength in ACL leg. Conclusion: A high level of validity makes isokinetic dynamometry the method for evaluation of thigh muscles strength and leaves this field of research open for new studies in order to improve both diagnostic and rehabilitation of patients with the insufficient ACL.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/fisiopatologia
Traumatismos em Atletas/fisiopatologia
Músculos Isquiotibiais/fisiopatologia
Força Muscular/fisiologia
Músculo Quadríceps/fisiopatologia
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Dinamômetro de Força Muscular
Qualidade de Vida
Ruptura/fisiopatologia
Coxa da Perna
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.2298/VSP141128067D


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[PMID]:29201295
[Au] Autor:Kim YK; Ahn JH; Yoo JD
[Ad] Endereço:Department of Orthopaedic Surgery, Ewha Womans University Mokdong Hospital, Seoul, Korea.
[Ti] Título:A Comparative Study of Clinical Outcomes and Second-Look Arthroscopic Findings between Remnant-Preserving Tibialis Tendon Allograft and Hamstring Tendon Autograft in Anterior Cruciate Ligament Reconstruction: Matched-Pair Design.
[So] Source:Clin Orthop Surg;9(4):424-431, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: This study aimed to compare stability, functional outcome, and second-look arthroscopic findings after anterior cruciate ligament reconstruction between remnant-preserving tibialis tendon allograft and remnant-sacrificing hamstring tendon autograft. Methods: We matched two groups (remnant-preserving tibialis tendon allograft group and hamstring tendon autograft group) in terms of demographic characteristics, associated injury, and knee characteristics. Each group consisted of 25 patients. Results: Operation time was longer in the remnant-preserving tibialis tendon allograft group, but there was no significant intergroup difference in stability, clinical outcome, and second-look arthroscopic findings. Conclusions: When an autograft is not feasible in anterior cruciate ligament reconstruction, the remnant-preserving technique can produce comparable results in terms of restoration of function, stability of the knee, and degree of synovium coverage at second-look arthroscopy compared to remnant-sacrificing hamstring autograft.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/cirurgia
Reconstrução do Ligamento Cruzado Anterior/métodos
Instabilidade Articular/etiologia
Articulação do Joelho/cirurgia
Tendões/transplante
[Mh] Termos MeSH secundário: Adolescente
Adulto
Aloenxertos
Lesões do Ligamento Cruzado Anterior/complicações
Reconstrução do Ligamento Cruzado Anterior/efeitos adversos
Artroscopia
Autoenxertos
Feminino
Seres Humanos
Imagem Tridimensional
Instabilidade Articular/diagnóstico por imagem
Articulação do Joelho/diagnóstico por imagem
Articulação do Joelho/fisiopatologia
Escore de Lysholm para Joelho
Masculino
Análise por Pareamento
Meia-Idade
Duração da Cirurgia
Estudos Retrospectivos
Cirurgia de Second-Look
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.424


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[PMID]:29360834
[Au] Autor:Behan FP; Maden-Wilkinson TM; Pain MTG; Folland JP
[Ad] Endereço:Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Loughborough University, Leicestershire, United Kingdom.
[Ti] Título:Sex differences in muscle morphology of the knee flexors and knee extensors.
[So] Source:PLoS One;13(1):e0190903, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Females experience higher risk of anterior cruciate ligament (ACL) injuries; males experience higher risk of hamstring strain injuries. Differences in injury may be partially due to sex differences in knee flexor (KF) to knee extensor (KE) muscle size ratio and the proportional size of constituent muscles. PURPOSE: To compare the absolute and proportional size, and mass distribution, of individual KE and KF muscles, as well as overall size and balance (size ratio) of these muscle groups between the sexes. METHODS: T1-weighted axial plane MR images (1.5T) of healthy untrained young males and females (32 vs 34) were acquired to determine thigh muscle anatomical cross-sectional area (ACSA). Maximal ACSA (ACSAmax) of constituent muscles, summated for KF and KE muscle groups, and the KF:KE ratio were calculated. RESULTS: Females had 25.3% smaller KE ACSAmax (70.9±12.1 vs 93.6±10.3 cm2; P<0.001) and 29.6% smaller KF ACSAmax than males (38.8±7.3cm2 vs 55.1±7.3cm2; P<0.001). Consequently, females had lower KF:KE ACSA ratio (P = 0.031). There were sex differences in the proportional size of 2/4 KE and 5/6 KF. In females, vastus lateralis (VL), biceps femoris long-head (BFlh) and semimembranosus (SM) were a greater proportion and sartorius (SA), gracilis (GR) and biceps femoris short-head (BFsh) a smaller proportion of their respective muscle groups compared to males (All P<0.05). CONCLUSION: Sex differences in KF:KE ACSAmax ratio may contribute to increased risk of ACL injury in females. Sex discrepancies in absolute and proportional size of SA, GR, VL and BFlh may contribute further anatomical explanations for sex differences in injury incidence.
[Mh] Termos MeSH primário: Joelho/anatomia & histologia
Músculo Esquelético/anatomia & histologia
[Mh] Termos MeSH secundário: Adolescente
Lesões do Ligamento Cruzado Anterior/etiologia
Feminino
Músculos Isquiotibiais/anatomia & histologia
Músculos Isquiotibiais/lesões
Músculos Isquiotibiais/fisiologia
Seres Humanos
Joelho/diagnóstico por imagem
Joelho/fisiologia
Traumatismos do Joelho/etiologia
Imagem por Ressonância Magnética
Masculino
Músculo Esquelético/diagnóstico por imagem
Músculo Esquelético/fisiologia
Tamanho do Órgão
Músculo Quadríceps/anatomia & histologia
Músculo Quadríceps/diagnóstico por imagem
Músculo Quadríceps/fisiologia
Fatores de Risco
Caracteres Sexuais
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180206
[Lr] Data última revisão:
180206
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180124
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0190903


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[PMID]:29205225
[Au] Autor:Czaplicki A; Kuniszyk-Józkowiak W; Jaszczuk J; Jarocka M; Walawski J
[Ad] Endereço:Józef Pilsudski University of Physical Education, Faculty of Physical Education and Sport, Department of Biomechanics and Computer Science, Biala Podlaska, Poland.
[Ti] Título:Using the discrete wavelet transform in assessing the effectiveness of rehabilitation in patients after ACL reconstruction.
[So] Source:Acta Bioeng Biomech;19(3):139-146, 2017.
[Is] ISSN:1509-409X
[Cp] País de publicação:Poland
[La] Idioma:eng
[Ab] Resumo:PURPOSE: The purpose of the current study was to assess the effectiveness of rehabilitation in patients after anterior cruciate ligament reconstruction (ACLR) using a wavelet analysis of the torque-time curve patterns of the extensors of the affected knee. The analysis aimed at the quantitative evaluation of irregularities in these torque-time patterns. METHODS: The study involved a group of 22 men who had had ACL reconstruction. The torque-time characteristics were recorded 3, 6 and 12 months after the surgery by an isokinetic dynamometer. They were then examined using the orthogonal Daubechies 4 (Db 4) and biorthogonal Bior 3.1 wavelets. RESULTS: A statistical analysis of the results revealed significant differences in values of the high-frequency energy stored in the details of the signal from the dynamometer between the first and last measurements, both for the Db 4 ( p ≤ 0.023) and Bior 3.1 ( p ≤ 0.01) wavelets. These differences were found in 73% of patients whose curve patterns were analysed using the Db 4 wavelet and in 82% of patients in the case of the Bior 3.1 wavelet. CONCLUSIONS: The wavelet transform proved to be an effective research tool in the qualitative evaluation of irregularities occurring in the curve patterns of the torque generated by the extensors of the ACL reconstructed knee. The findings of the study suggest that time-frequency analyses of these characteristics can be of practical importance, as they help assess the state of the patient's knee joint and his progress in rehabilitation after ACLR.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/diagnóstico
Lesões do Ligamento Cruzado Anterior/terapia
Reconstrução do Ligamento Cruzado Anterior/reabilitação
Diagnóstico por Computador/métodos
Teste de Esforço/métodos
Análise de Ondaletas
[Mh] Termos MeSH secundário: Adulto
Algoritmos
Lesões do Ligamento Cruzado Anterior/fisiopatologia
Seres Humanos
Articulação do Joelho/fisiopatologia
Masculino
Contração Muscular
Força Muscular
Músculo Esquelético/fisiopatologia
Avaliação de Resultados (Cuidados de Saúde)/métodos
Reprodutibilidade dos Testes
Sensibilidade e Especificidade
Processamento de Sinais Assistido por Computador
Terapia Assistida por Computador/métodos
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180129
[Lr] Data última revisão:
180129
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171206
[St] Status:MEDLINE


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[PMID]:28455730
[Au] Autor:Bates NA; Nesbitt RJ; Shearn JT; Myer GD; Hewett TE
[Ad] Endereço:Departments of Orthopedic Surgery and Physiology and Biomedical Engineering, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA. batesna@gmail.com.
[Ti] Título:Knee Abduction Affects Greater Magnitude of Change in ACL and MCL Strains Than Matched Internal Tibial Rotation In Vitro.
[So] Source:Clin Orthop Relat Res;475(10):2385-2396, 2017 Oct.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Anterior cruciate ligament (ACL) injures incur over USD 2 billion in annual medical costs and prevention has become a topic of interest in biomechanics. However, literature conflicts persist over how knee rotations contribute to ACL strain and ligament injury. To maximize the efficacy of ACL injury prevention, the effects of underlying mechanics need to be better understood. QUESTIONS/PURPOSES: We applied robotically controlled, in vivo-derived kinematic stimuli to the knee to assess ligament biomechanics in a cadaver model. We asked: (1) Does the application of abduction rotation increase ACL and medial collateral ligament (MCL) strain relative to the normal condition? (2) Does the application of internal tibial rotation impact ACL strain relative to the neutral condition? (3) Does combined abduction and internal tibial rotation increase ligament strain more than either individual contribution? METHODS: A six-degree-of-freedom robotic manipulator was used to position 17 cadaveric specimens free from knee pathology outside of low-grade osteoarthritis (age, 47 ± 8 years; 13 males, four females) into orientations that mimic initial contact recorded from in vivo male and female drop vertical jump and sidestep cutting activities. Four-degree rotational perturbations were applied in both directions from the neutral alignment position (creating an 8° range) for each frontal, transverse, and combined planes while ACL and MCL strains were continuously recorded with DVRT strain gauges implanted directly on each ligament. Analysis of variance models with least significant difference post hoc analysis were used to assess differences in ligament strain and joint loading between sex, ligament condition, or motion task and rotation type. RESULTS: For the female drop vertical jump simulation in the intact knee, isolated abduction and combined abduction/internal rotational stimuli produced the greatest change in strain from the neutral position as compared with all other stimuli within the ACL (1.5% ± 1.0%, p ≤ 0.035; 1.8% ± 1.3%, p ≤ 0.005) and MCL (1.8% ± 1.0%, p < 0.001; 1.6% ± 1.3%, p < 0.001) compared with all other applied stimuli. There were no differences in mean peak ACL strain between any rotational stimuli (largest mean difference = 2.0%; 95% confidence interval [CI], -0.9% to 5.0%; p = 0.070). These trends were consistent for all four simulated tasks. Peak ACL strain in the intact knee was larger than peak MCL strain for all applied rotational stimuli in the drop vertical jump simulations (smallest mean difference = 2.1%; 95% CI, -0.4% to 4.5%; p = 0.047). CONCLUSIONS: Kinematically constrained cadaveric knee models using peak strain as an outcome variable require greater than 4° rotational perturbations to elicit changes in intraarticular ligaments. CLINICAL RELEVANCE: Because combined rotations and isolated abduction produced greater change in strain relative to the neutral position for the ACL and MCL than any other rotational stimuli in this cadaver study, hypotheses for in vivo investigations aimed toward injury prevention that focuses on the reduction of frontal plane knee motion should be considered. Furthermore, reduced strain in the MCL versus the ACL may help explain why only 30% of ACL ruptures exhibit concomitant MCL injuries.
[Mh] Termos MeSH primário: Lesões do Ligamento Cruzado Anterior/fisiopatologia
Ligamento Cruzado Anterior/fisiopatologia
Articulação do Joelho/fisiopatologia
Ligamento Colateral Médio do Joelho/fisiopatologia
Entorses e Distensões/fisiopatologia
Tíbia/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Lesões do Ligamento Cruzado Anterior/diagnóstico
Lesões do Ligamento Cruzado Anterior/prevenção & controle
Fenômenos Biomecânicos
Cadáver
Feminino
Seres Humanos
Masculino
Ligamento Colateral Médio do Joelho/lesões
Meia-Idade
Amplitude de Movimento Articular
Robótica/métodos
Entorses e Distensões/diagnóstico
Entorses e Distensões/prevenção & controle
Estresse Mecânico
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180124
[Lr] Data última revisão:
180124
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170430
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5367-9



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