The optimal anesthetic technique for outpatient knee arthroscopy remains controversial. In this study, we evaluated surgical operating conditions, patient satisfaction, recovery times, and postoperative analgesic requirements associated with psoas compartment block, general anesthetic, or spinal anesthetic techniques. Sixty patients were randomized to receive a propofol/nitrous oxide/fentanyl general anesthetic, spinal anesthesia with 6 mg of bupivacaine and 15 micro g of fentanyl, or ...

BACKGROUND: Femoral nerve block (FNB) has become a popular method of postoperative analgesia for anterior cruciate ligament (ACL) reconstruction in pediatric and adolescent patients. Successful rehabilitation after surgery involves return of quadriceps and hamstring strength.

PURPOSE: To compare knee strength and function 6 months after ACL reconstruction in pediatric and adolescent patients who received FNB versus patients with no nerve block.

STUDY DESIGN: Cohort study; Level of ...

The purpose of this study was to determine if quadriceps strength and functional outcomes were similar at 6 months following anterior cruciate ligament [ACL] reconstruction in patients receiving a continuous 48-hour femoral nerve blockade for postoperative analgesia (FNB group) versus patients with no FNB (control group). A retrospective cohort was designed including athletes who underwent primary ACL reconstruction with patellar tendon autograft between 2005 and 2010 at our institution ...

BACKGROUND: There is a paucity of clinical information to guide the treatment of a combined anterior cruciate ligament (ACL) tear and Segond fracture.

PURPOSE: To compare clinical outcomes, graft failure rates, and activity levels between patients undergoing ACL reconstruction (ACLR) with and without an untreated Segond fracture at a minimum 2-year follow-up.

STUDY DESIGN: Cohort study; Level of evidence, 3.

METHODS: This study included a group of patients with a combined ACL ...

A cohort of 282 elite amateur ice hockey players were analyzed to 1) record the number, type, location, and severity of head, neck, and facial injuries sustained during games; 2) examine the relationship between injuries and the type of facial protection (none, partial, or full) according to individual playing time; and 3) determine whether full or partial facial protection is associated with an increased incidence of concussions, eye injuries, and neck injuries. Fifty-two injuries ...

BACKGROUND: Peroneal nerve palsy is a frequent and potentially disabling complication of multiligament knee dislocation, but little information exists on the degree to which patients recover motor or sensory function after this injury, and whether having this nerve injury--with or without complete recovery--is a predictor of inferior patient-reported outcome scores.

QUESTIONS/PURPOSES: The purposes of this study were to (1) report on motor and sensory recovery as well as patient-reported ...

BACKGROUND: Female soccer players have a well-known risk for anterior cruciate ligament (ACL) injury, but few studies have reported on second ACL injuries in this population.

PURPOSE: To (1) report the rates of subsequent ACL injury (ipsilateral graft rupture or contralateral tear) in competitive female soccer players, (2) compare these rates with those of other female athletes of similar competitive level, (3) determine risk factors for second ACL injury, and (4) report clinical outcome ...

BACKGROUND: Reconstruction of anterior cruciate ligament (ACL) tears may potentially prevent the development of secondary meniscal injuries and arthritis.

PURPOSE/HYPOTHESIS: The purpose of this study was to (1) evaluate the protective benefit of ACL reconstruction (ACLR) in preventing subsequent meniscal tears or arthritis, (2) determine if earlier ACLR (<1 year after injury) offers greater protective benefits than delayed reconstruction (≥1 year after injury), and (3) evaluate factors ...

OBJECTIVE: To summarize previously published findings and to present the opinions of a group of reconstructive orthopedic surgeons from a single institution on participation in sports after hip or knee arthroplasty.

DESIGN: We reviewed the literature pertaining to participation in sports after hip or knee arthroplasty and surveyed a group of orthopedic surgeons about their recommendations for resumption of various sports activities by patients who had undergone total hip or knee ...

BACKGROUND: There are sparse data available regarding outcome of meniscal repair performed at the time of ACL reconstruction in the pediatric and adolescent population.

PURPOSE: To review the results of meniscal repair performed at the time of ACL reconstruction in pediatric and adolescent patients.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: The records of all patients age 18 years or younger who underwent meniscal repair at the time of ACL reconstruction between 1990 and ...

PurposeThe purpose of this study is to assess the reliability of measuring the tibial tubercle to posterior cruciate (TT-PCL) distance compared to the tibial tubercle to trochlear groove (TT-TG) distance on magnetic resonance imaging (MRI), establish baseline TT-PCL values in patellar instability patients, and determine the predictive value of an excessive TT-PCL distance (≥24 mm) for recurrent patellar instability compared to a TT-TG distance ≥20 mm.MethodsTT-TG and TT-PCL distances ...

BACKGROUND: As anterior cruciate ligament (ACL) reconstruction is performed increasingly in the United States, the rate of revision ACL reconstruction continues to rise. A paucity of literature exists with respect to repeat ACL revision surgery.

PURPOSE: To evaluate the functional outcomes of patients who had undergone at least 2 revision ACL reconstructions.

STUDY DESIGN: Case series; Level of evidence, 4.

METHODS: The records of all patients who had undergone repeat revision ACL ...

Between 1990 and 1995, 25 painful primary posterior cruciate ligament retaining total knee arthroplasties were revised for flexion instability. These patients shared typical clinical presentations that included a sense of instability without frank giving way, recurrent knee joint effusion, soft tissue tenderness involving the pes anserine tendons and the retinacular tissue, posterior instability of 2+ or 3+ with a posterior drawer or a posterior sag sign at 90 degrees flexion, and above ...

BACKGROUND: Tibial tubercle-trochlear groove distance (TT-TG) is a commonly used measurement for surgical decision making in patients with patellofemoral malalignment and instability. This measurement has historically been performed utilizing axial computed tomography (CT). More recently, magnetic resonance imaging (MRI) has been proposed as an equivalent method, but this has not yet been fully validated.

PURPOSE: To determine the reliability of TT-TG distance measurements on both MRI ...

BACKGROUND: Treatment of the multiligament-injured knee remains controversial.

PURPOSE: To compare clinical and functional outcomes of a consecutive series of multiligament-injured knees that underwent repair of the fibular collateral ligament (FCL) and posterolateral corner (PLC), followed by delayed cruciate ligament reconstructions, with those that had single-stage multiligament reconstruction.

STUDY DESIGN: Cohort study; Level of evidence, 3. Methods Patients with multiligament knee ...