Analysis of intercondylar notch size and shape in patients with cyclops syndrome after anterior cruciate ligament reconstruction.

BACKGROUND: Cyclops lesion is the second most common cause of extension loss after anterior cruciate ligament reconstruction. This study focused on the correlation between the anatomy of the intercondylar notch and the incidence of cyclops lesion. To determine whether the size and shape of the intercondylar notch are related to cyclops lesion formation following anterior cruciate ligament reconstruction according to magnetic resonance imaging (MRI) findings. METHODS: One hundred twenty-five (125) patients were retrospectively evaluated. The notch width index (NWI) and notch shape index (NSI) were measured based on coronal and axial MRI sections in patients diagnosed with cyclops syndrome (n = 25), diagnosed with complete anterior cruciate ligament (ACL) tears (n = 50), and without cyclops lesions or ACL ruptures (n = 50). RESULTS: Imaging analysis results showed that the cyclops and ACL groups had lower mean NWI and NSI values than the control group. Significant between-group differences were found in NSI (p = 0.0140) based on coronal cross-sections and in NWI (p = 0.0026) and NSI (p < 0.0001) based on axial sections. CONCLUSIONS: The geometry of the intercondylar notch was found to be associated with the risk of cyclops lesion formation and ACL rupture.

Lateral Extra-articular Tenodesis with Iliotibial Band Strip - a Solution for Anterolateral Instability?

It is widely acknowledged that anterior cruciate ligament (ACL) injury is the cause of anterolateral insta-bility, but in some cases not only the ACL ruptures, but also anterolateral structures (ALS), including the antero-lateral ligament. Their insufficiency may be the cause of residual instability after ACL reconstruction, which significantly increases the risk of graft rupture. In the past, anterolateral instability caused by ACL injury was treat-ed with extra-articular reconstructions, including lateral extra-articular tenodesis. Nowadays those techni-ques are used simultaneously in cases of complex anterolateral and rotational instability. This article briefly describes historical methods of lateral tenodesis and presents step-by-step two techniques used in our depart-ments involving two alternative graft femoral fixation methods.

Gene variants within the COL1A1 gene are associated with reduced anterior cruciate ligament injury in professional soccer players.

OBJECTIVES: To examine the association of the COL1A1 -1997G/T and +1245G/T polymorphisms, individually and as haplotypes, with anterior cruciate ligament ruptures in professional soccer players. DESIGN: Subjects were 91 male professional soccer players with surgically diagnosed primary anterior cruciate ligament ruptures. The control group consisted of 143 apparently healthy male professional soccer players, who were without any self-reported history of ligament or tendon injury. Both subjects and healthy controls are from the same soccer teams, of the same ethnicity (Polish, East-Europeans for ≥3 generations), a similar age category, and had a comparable level of exposure to anterior cruciate ligament injury. METHODS: Genomic DNA was extracted from the oral epithelial cells using GenElute Mammalian Genomic DNA Miniprep Kit (Sigma, Germany). All samples were genotyped using a Rotor-Gene real-time polymerase chain reaction. RESULTS: Genotype distributions for both polymorphisms met the Hardy-Weinberg expectations in both subjects and controls (p>0.05). Higher frequency of the COL1A1 G-T (-1997G/T and +1245G/T polymorphisms) haplotype was significantly associated with reduced risk for anterior cruciate ligament rupture (Hap.score -1.98, p=0.048). The TT genotype was under-represented in the anterior cruciate ligament rupture group. However, this result was not statistically significant (p=0.084 Fisher's exact test, recessive mode: TT vs GT+GG). CONCLUSIONS: Higher frequency of the COL1A1 G-T haplotype is associated with reduced risk of anterior cruciate ligament injury in a group of professional soccer players. Consequently, carrying two copies the COL1A1 G-T haplotype may be protective against anterior cruciate ligament injury.

Application of platelet rich plasma in sports medicine.

Any new method of treatment is associated with high expectations for its success, particularly if the therapy is based not only on the premise of achieving a symptomatic effect, but also improving functional quality and repairing structurally damaged tissues. Platelet Rich Plasma (PRP) application was shown to be a successful catalyst in the healing process for a wide variety of conditions in animal and human models. However, its use has been controversial due to many types of the PRP definition, optimal concentration, and modalities of implementation. In the qualification of patients for PRP treatment, not only should medical indications be considered, but also the role of participation in therapy with a physiotherapist supervising physical parameters and techniques used during recovery time. Further study is required in order to define optimal handling procedures of PRP injection. Long-term follow up will reveal if the promise of this substance can be realized and implemented to maximize its potential as a therapeutic remedy.

Ultrasound measurement of rotator cuff thickness and acromio-humeral distance in the diagnosis of subacromial impingement syndrome of the shoulder.

The usefulness of ultrasound measurements in the diagnosis of the subacromial impingement syndrome of the shoulder was evaluated. Fifty-seven patients with unilateral symptoms of the impingement syndrome underwent ultrasound examination of both shoulder joints, which included assessment of rotator cuff integrity, measurement of rotator cuff thickness and the distance between the infero-lateral edge of acromion and the apex of the greater tuberosity of humerus (AGT distance) in the standard ultrasonographic positions. As a control group, 36 volunteers (72 shoulders) with no history of shoulder pain were examined sonographically. Ultrasonographic assessment of humeral head elevation, measured as the AGT distance, proved to be useful in establishing the diagnosis of the subacromial impingement syndrome of the shoulder. A difference in rotator cuff thickness of more than 1.1 mm and a difference in the AGT distance of more than 2.1 mm between both shoulder joints may reflect dysfunction of rotator cuff muscles.