Knee Publications Archives - Jorge Chahla, MD, PhD https://www.jorgechahlamd.com/category/knee-publications/ Thu, 03 Jun 2021 22:20:57 +0000 en-US hourly 1 https://wordpress.org/?v=7.1.4 Type II Medial Meniscus Root Repair With Peripheral Release for Addressing Meniscal Extrusion https://www.jorgechahlamd.com/type-ii-medial-meniscus-root-repair-with-peripheral-release-for-addressing-meniscal-extrusion/ Thu, 03 Jun 2021 22:20:57 +0000 https://www.jorgechahlamd.com/?p=2516 PMID: 31687324 Medial meniscal root tears are often disabling injuries that can occur in isolation during low-velocity, deep knee flexion movements in middle-aged patients. These lesions often demonstrate a type II pattern, which is described by a tear perpendicular to the fibers of the meniscus near its attachment to the tibia. These injuries have been...read more

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]]> The Influence of Graft Tensioning Sequence on Tibiofemoral Orientation During Bicruciate and Posterolateral Corner Knee Ligament Reconstruction: A Biomechanical Study https://www.jorgechahlamd.com/the-influence-of-graft-tensioning-sequence-on-tibiofemoral-orientation-during-bicruciate-and-posterolateral-corner-knee-ligament-reconstruction-a-biomechanical-study/ Thu, 03 Jun 2021 22:15:51 +0000 https://www.jorgechahlamd.com/?p=2513 When multiple ligaments are reconstructed during knee surgery, the order of tensioning each graft can affect alignment of the tibia and femur. If the resulting alignment varies from what naturally occurs, issues such as instability and graft failure may arise. This study evaluated whether the order of tensioning anterior cruciate ligament (ACL), posterior cruciate ligament...read more

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]]> Quantitative and Qualitative Assessment of Posterolateral Meniscal Anatomy: Defining the Popliteal Hiatus, Popliteomeniscal Fascicles, and the Lateral Meniscotibial Ligament https://www.jorgechahlamd.com/quantitative-and-qualitative-assessment-of-posterolateral-meniscal-anatomy-defining-the-popliteal-hiatus-popliteomeniscal-fascicles-and-the-lateral-meniscotibial-ligament/ Thu, 03 Jun 2021 21:46:38 +0000 https://www.jorgechahlamd.com/?p=2489 PMID: 31136201 Surgical treatment of lateral meniscal tears can be challenging due to the greater mobility of the lateral meniscus, thin capsule, and management of the popliteal hiatus. In such instances, having a detailed understanding of relevant anatomy is important. Using cadaveric knees and a 3-dimensional coordinate measuring system, this study aimed to measure the...read more

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]]> Single-Stage Multiple-Ligament Knee Reconstructions for Sports-Related Injuries: Outcomes in 194 Patients https://www.jorgechahlamd.com/single-stage-multiple-ligament-knee-reconstructions-for-sports-related-injuries-outcomes-in-194-patients/ Thu, 03 Jun 2021 21:39:03 +0000 https://www.jorgechahlamd.com/?p=2484 Multi-ligament knee injuries in the young and active population can be devastating. This case series sought to report outcomes following sports-related single-stage multi-ligament knee reconstructions. Over a 6-year period, 194 patients that sustained injury to least two out of four major knee ligaments (anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), superficial medial collateral ligament...read more

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]]> Platelet-Rich Plasma Augmentation in Meniscal Repair Surgery: A Systematic Review of Comparative Studies https://www.jorgechahlamd.com/platelet-rich-plasma-augmentation-in-meniscal-repair-surgery-a-systematic-review-of-comparative-studies/ Tue, 18 May 2021 18:53:27 +0000 https://www.jorgechahlamd.com/?p=2465 PMID: 32057981 Meniscal lesions occur frequently in athletes and the general population, with approximately 1 million meniscal surgical procedures in the United States each year. For patients with chronic, degenerative tears, meniscal injuries may not be able to heal and require meniscectomy, which involves removal of the meniscus. However, lesions of the peripheral meniscus or...read more

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]]> Quantitative and Qualitative Analysis of the Medial Patellar Ligaments: An Anatomic and Radiographic Study https://www.jorgechahlamd.com/quantitative-and-qualitative-analysis-of-the-medial-patellar-ligaments-an-anatomic-and-radiographic-study/ Tue, 18 May 2021 18:47:01 +0000 https://www.jorgechahlamd.com/?p=2460 Previous literature is lacking in a description of the medial stabilizing ligaments of the kneecap in relation to surrounding structures and one another. In this study, the attachments of the following ligaments were analyzed in relation to bony and soft tissue structures using cadavers: medial patellofemoral ligament (MPFL), medial patellotibial ligament (MPTL), medial patellomeniscal ligament...read more

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]]> Meniscus Root Repair vs Meniscectomy or Nonoperative Management to Prevent Knee Osteoarthritis After Medial Meniscus Root Tears: Clinical and Economic Effectiveness https://www.jorgechahlamd.com/meniscus-root-repair-vs-meniscectomy-or-nonoperative-management-to-prevent-knee-osteoarthritis-after-medial-meniscus-root-tears-clinical-and-economic-effectiveness/ Tue, 18 May 2021 18:28:45 +0000 https://www.jorgechahlamd.com/?p=2444 PMID: 29517925 Most medial meniscus root tears occur in patients in their fourth or fifth decades of life, causing moderate to severe joint-line pain. Historically, surgeons have elected to treat these tears nonoperatively or by meniscectomy. Unfortunately, clinical studies have shown that these options can accelerate degeneration of cartilage and subsequently require total knee replacement. Meniscus...read more

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]]> Posterior Cruciate Ligament Injuries of the Knee at the National Football League Combine: An Imaging and Epidemiology Study https://www.jorgechahlamd.com/posterior-cruciate-ligament-injuries-of-the-knee-at-the-national-football-league-combine-an-imaging-and-epidemiology-study/ Tue, 18 May 2021 18:23:56 +0000 https://www.jorgechahlamd.com/?p=2440 In this study, posterior cruciate ligament (PCL) injuries in players in the National Football League (NFL) Combine were analyzed to define epidemiology by player position, concurrent injury rate, and draft success with injury from 2009 – 2015. This injury is of particular interest due to the high risk of osteoarthritis development when combined with chondral...read more

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]]> Meniscal Root Tears https://www.jorgechahlamd.com/meniscal-root-tears/ Tue, 18 May 2021 18:07:22 +0000 https://www.jorgechahlamd.com/?p=2428 PMID: 31054709 Meniscus root tears are a specific type of meniscal injury that have gained attention over the past several years. They are defined as lesions either directly at the attachment point between the meniscus and tibia, or within 1 cm of that insertion. These injuries result in failure of the menisci to properly absorb...read more

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]]> Perioperative Blood Flow Restriction Rehabilitation in Patients Undergoing ACL Reconstruction: A Systematic Review https://www.jorgechahlamd.com/perioperative-blood-flow-restriction-rehabilitation-in-patients-undergoing-acl-reconstruction-a-systematic-review/ Mon, 17 May 2021 07:49:02 +0000 https://www.jorgechahlamd.com/?p=2423 Blood flow restriction (BFR) rehabilitation is an emerging trend in sports medicine, especially in the setting of anterior cruciate ligament (ACL) reconstruction. BFR involves placing a cuff around the thigh that decreases the amount of blood in the knee during low-intensity resistance training and has been shown to increase muscle size via the lack of...read more

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]]> Meniscal Repair in Pediatric Populations: A Systematic Review of Outcomes https://www.jorgechahlamd.com/meniscal-repair-in-pediatric-populations-a-systematic-review-of-outcomes/ Mon, 17 May 2021 07:31:41 +0000 https://www.jorgechahlamd.com/?p=2407 PMID: 31205961 The loss of healthy meniscal tissue in pediatric populations has been shown to have many negative long term consequences on joint health, including higher rates of early-onset osteoarthritis pain and lower quality of overall life. Thus, meniscal preservation is of high importance for this particular group, especially with recent reports of increasing knee...read more

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]]> Multiple Ligament Reconstruction Femoral Tunnels: Intertunnel Relationships and Guidelines to Avoid Convergence https://www.jorgechahlamd.com/multiple-ligament-reconstruction-femoral-tunnels-intertunnel-relationships-and-guidelines-to-avoid-convergence/ Mon, 17 May 2021 07:27:48 +0000 https://www.jorgechahlamd.com/?p=2402 When multiple knee ligaments require reconstruction, there is a possibility of the tunnels drilled for each graft crossing paths (tunnel convergence). Through use of 3D knee models, the risk of tunnel convergence for anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), fibular collateral ligament (FCL), popliteus tendon (PLT), superficial medial collateral ligament (sMCL), and posterior...read more

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]]> Influence of Meniscal and Chondral Lesions on Patient-Reported Outcomes After Primary Anterior Cruciate Ligament Reconstruction at 2-Year Follow-up https://www.jorgechahlamd.com/influence-of-meniscal-and-chondral-lesions-on-patient-reported-outcomes-after-primary-anterior-cruciate-ligament-reconstruction-at-2-year-follow-up/ Thu, 04 Feb 2021 20:30:45 +0000 https://www.jorgechahlamd.com/?p=2353 PMID: 29468171 Reports have shown that 30% to 60% of those with ACL tears also demonstrate either meniscal or chondral injuries at the time of their ACL reconstruction surgery. Although these lesions concurrent with ACL tears have been associated with more rapid progression of osteoarthritis, their effects have not entirely been characterized. Given how this information...read more

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]]> Effect of Meniscocapsular and Meniscotibial Lesions in ACL-Deficient and ACL-Reconstructed Knees: A Biomechanical Study https://www.jorgechahlamd.com/effect-of-meniscocapsular-and-meniscotibial-lesions-in-acl-deficient-and-acl-reconstructed-knees-a-biomechanical-study/ Thu, 04 Feb 2021 20:21:59 +0000 https://www.jorgechahlamd.com/?p=2346 The medial meniscus is connected to the knee joint capsule at the meniscocapsular attachment (MCA) and to the tibia at the meniscotibial attachment (MTA). Tears of the MCA, historically termed “ramp” lesions” have been reported in up to 17% of anterior cruciate ligament (ACL) tears. However, debate exists over whether ramp lesions are due to...read more

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]]> Diagnostic Performance of Artificial Intelligence for Detection of Anterior Cruciate Ligament and Meniscus Tears: A Systematic Review https://www.jorgechahlamd.com/diagnostic-performance-of-artificial-intelligence-for-detection-of-anterior-cruciate-ligament-and-meniscus-tears-a-systematic-review/ Thu, 04 Feb 2021 19:56:03 +0000 https://www.jorgechahlamd.com/?p=2328 PMID: 32956803 Imaging-based detection of anterior cruciate ligament (ACL) injuries use magnetic resonance imaging (MRI) as its current gold standard for diagnosis. However, the accuracy of these MRI readings may decrease due to observer inexperience, presence of multiple injuries, and small or incomplete tears that are difficult to detect. Artificial intelligence (AI) technology has helped...read more

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]]> Anterolateral Knee Extra-articular Stabilizers: A Robotic Study Comparing Anterolateral Ligament Reconstruction and Modified Lemaire Lateral Extra-articular Tenodesis https://www.jorgechahlamd.com/anterolateral-knee-extra-articular-stabilizers-a-robotic-study-comparing-anterolateral-ligament-reconstruction-and-modified-lemaire-lateral-extra-articular-tenodesis/ Thu, 04 Feb 2021 19:47:43 +0000 https://www.jorgechahlamd.com/?p=2323 Anterior cruciate ligament (ACL) injuries are commonplace in the world of sports medicine and are often treated with ACL reconstruction. Following reconstruction, however, patients may continue to experience knee instability. This study aimed to determine the impact of the anterolateral structures on knee stability in the setting of ACL reconstruction using cadaveric knees. The stability...read more

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]]> Biological Treatment of the Knee with Platelet-Rich Plasma or Bone Marrow Aspirate Concentrates https://www.jorgechahlamd.com/biological-treatment-of-the-knee-with-platelet-rich-plasma-or-bone-marrow-aspirate-concentrates/ Thu, 04 Feb 2021 19:26:03 +0000 https://www.jorgechahlamd.com/?p=2310 Knee pathologies including focal cartilage injuries, osteoarthritis and ligament injuries are common. The use of biologic agents has emerged as an option for treating these diseases. Platelet-rich plasma (PRP) has gained significant interest for treating common sports medicine injuries. Intra-articular PRP injections for the treatment of focal chondral defects and early mild to moderate osteoarthritis...read more

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]]> Assessing the Resident Progenitor Cell Population and the Vascularity of the Adult Human Meniscus https://www.jorgechahlamd.com/assessing-the-resident-progenitor-cell-population-and-the-vascularity-of-the-adult-human-meniscus/ Thu, 14 Jan 2021 00:36:38 +0000 https://www.jorgechahlamd.com/?p=2303 Surgical treatment of meniscal tears involves either meniscal repair or meniscectomy, which is the removal of the damaged meniscus. Recent studies have reported meniscectomies to significantly reduce the career lengths of professional athletes, while repairs demonstrated higher success rates at long-term follow-up. However, it still remains relatively unclear whether repair or resection would be favorable...read more

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]]> Reconstruction and Repair of the Anterior Cruciate Ligament (ACL) https://www.jorgechahlamd.com/reconstruction-and-rrepair-of-the-anterior-cruciate-ligament-acl/ Thu, 14 Jan 2021 00:22:56 +0000 https://www.jorgechahlamd.com/?p=2298 Reconstruction and repair of the anterior cruciate ligament (ACL) are both effective in restoring knee stability following ACL injury. This was demonstrated by applying force to cadaveric knees at different degrees of flexion to simulate normal forces experienced by a human knee in various positions (see image). Motion tracking was used to determine how far...read more

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]]> Clinical Outcomes of Inside-Out Meniscal Repair According to Anatomic Zone of the Meniscal Tear https://www.jorgechahlamd.com/clinical-outcomes-of-inside-out-meniscal-repair-according-to-anatomic-zone-of-the-meniscal-tear/ Wed, 13 Jan 2021 23:54:47 +0000 https://www.jorgechahlamd.com/?p=2283 Within the meniscus, three anatomical zones have been described based on varying levels of vascularity. The “red-red” zone is on the periphery of the meniscus and has been reported to be the most vascular, whereas the middle “red-white” and innermost “white-white” zones have progressively less vascularization. It is unclear how much these varying levels of...read more

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]]> Anterior Cruciate Ligament Injury at the Time of Anterior Tibial Spine Fracture in Young Patients: An Observational Cohort Study https://www.jorgechahlamd.com/anterior-cruciate-ligament-injury-at-the-time-of-anterior-tibial-spine-fracture-in-young-patients-an-observational-cohort-study/ Wed, 13 Jan 2021 23:51:19 +0000 https://www.jorgechahlamd.com/?p=2279 The relationship between anterior tibial spine fractures (ATSF) and anterior cruciate ligament (ACL) injury in the pediatric population has not been defined though the injuries may occur together. ATSF occur at the point on the tibia where the ACL attaches and are thought to be seen more frequently in the pediatric population because of weaker...read more

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