Anterior Cruciate Ligament Injuries

MISSION, Kan., March 11, 2024 /PRNewswire/ -- (Family Features) Millions of people experience chronic pain, with knee pain among the most common. Athletes and active adults know the impact activities like running and skiing can have on their knees, but when chronic knee pain makes it difficult to do those activities, or even day-to-day tasks like walking up the stairs, people may often face challenges. Continue Reading Photos courtesy of Shutterstock Photos courtesy of Shutterstock According to the journal "Cartilage," unlike other tissues, cartilage does not repair itself and, without proper treatment, can worsen over time and become more difficult to treat. However, options like FDA-approved knee cartilage repair surgery MACI (autologous cultured chondrocytes on porcine collagen membrane) uses a patient's cells to help repair cartilage defects and may help alleviate knee pain. "Sports-related pain should be evaluated quickly, especially when it's difficult to put weight on the knee, swelling occurs or there is restricted range of motion," said Dr. Alexander Meininger, orthopedic surgeon and MACI consultant. Justin Keys, a former patient of Meininger and avid skier, knows that the long-term outcomes of knee cartilage surgery can be worth the short-term sacrifices. After several injuries, including an ACL injury, Keys struggled with most activities except walking on flat, paved surfaces. After consulting with Meininger, Keys chose knee cartilage repair to help get back to his active lifestyle. Keys considered whether to manage the injury as-is or choose MACI and undergo rehabilitation to potentially get back to his favorite activities in the future. He knew he could no longer use short-term relief methods and had to address his pain with a treatment to help provide lasting relief. For athletes like Keys who want to fix knee pain, it's important to consider these steps: Discuss Options with Your Doctor Patients should talk to their doctors and undergo an MRI to help assess the internal structures of the knee. Meininger recommends patients and their doctors discuss options for long-term knee restoration health, preserving function for future decades and recognizing the short-term sacrifice. Set Yourself Up for Success Experts like Meininger suggest patients take steps ahead of surgery to help their recovery. "The important thing is to be as fit as possible and use the preseason months to undergo surgery and rehab," Meininger said. Patients can take steps to prep their home for recovery, which may include: Bringing necessities down from hard-to-reach shelves Moving furniture to ensure clear pathways Installing shower safety handles to minimize potential falls The Road to Rehab and Recovery Rehabilitation takes time and everyone's experience is unique. It can be as much of a mental challenge as it is physical. Committing to a physical therapy regime, staying hydrated and eating well are important aspects to support recovery. Patients should talk to their doctors with questions and before starting any exercises. IMPORTANT SAFETY INFORMATION Do not use if you are allergic to antibiotics such as gentamicin or materials from cow or pig; have severe osteoarthritis of the knee, other severe inflammatory conditions, infections or inflammation in the bone joint and other surrounding tissue or blood clotting conditions; had knee surgery in the past 6 months, not including surgery for obtaining a cartilage biopsy or a surgical procedure to prepare your knee for a MACI implant; or cannot follow a rehabilitation program post-surgery. MACI is used for the repair of symptomatic cartilage damage of the adult knee. Conditions that existed before your surgery, including meniscus tears, joint or ligament instability or alignment problems should be evaluated and treated before or at the same time as the MACI implant. MACI is not recommended if you are pregnant. MACI has not been studied in patients younger than 18 or over 55 years of age. Common side effects include joint pain, tendonitis, back pain, joint swelling and joint effusion. More serious side effects include joint pain, cartilage or meniscus injury, treatment failure and osteoarthritis. See Full Prescribing Information for more information. Find more information by visiting MACI.com. *Testimonials by MACI patient and paid Vericel consultant Photos courtesy of Shutterstock Michael French [email protected] 1-888-824-3337 editors.familyfeatures.com About Family Features Editorial Syndicate A leading source for high-quality food, lifestyle and home and garden content, Family Features provides readers with topically and seasonally relevant tips, takeaways, information, recipes, videos, infographics and more. Find additional articles and information at Culinary.net and eLivingToday.com. SOURCE Family Features Editorial Syndicate

SAN FRANCISCO, Feb. 12, 2024 /PRNewswire/ -- Experts from NYU Langone Orthopedics will present their latest clinical findings and research discoveries at the American Academy of Orthopaedic Surgeons' (AAOS) 2024 Annual Meeting, February 12-16, in San Francisco. Among the topics presented: improved outcomes in computer-navigated and robot-assisted total knee replacements substantial reduction in post-operative complications in patients with significant weight loss before lumbar spinal fusion surgery an improved mental state after hip fracture repair surgery through an alternative method to general anesthesia in hip fracture repair surgery Understanding the differences in posterior tibial slope in unilateral versus bilateral ACL reconstruction "The faculty of our department are always focused on uncovering new, innovative ways to heal while improving the patient experience and outcomes," said Joseph D. Zuckerman, MD, FAAOS, the Walter A. L. Thompson Professor of Orthopedic Surgery, chair of the Department of Orthopedic Surgery at NYU Langone, and a former president of AAOS. "This year's impressive group of presentations at the nation's premier orthopedic meeting is a testament to why NYU Langone Orthopedics endeavors to always deliver world-class care to our patients." NYU Langone Orthopedics is ranked No. 4 in the nation by U.S. News and World Report, performing more than 34,000 orthopedic procedures annually by more than 200 orthopedic physician faculty. At this year's meeting, faculty of NYU Langone Orthopedics will present 39 posters, 31 e-posters, 34 papers, 31 videos, and 21 symposia, courses, specialty programs, and special sessions. Below are some of the notable presentations from this year's conference: Podium Presentation: Use of Technology Improves Short-Term Clinical Outcomes in Total Knee Arthroplasty The use of technology in total knee replacements, including computer-navigated and robot-assisted surgical systems, has increased in recent years, but the effect on patient-reported outcomes has been unclear. Surgeons at NYU Langone endeavored to determine short-term patient outcomes using these minimally invasive, precision-based technologies. "Technological innovations have enabled surgeons to improve implant positioning and accuracy, and we're seeing that positively impact the patient experience," said Morteza Meftah, MD, an associate professor of orthopedic surgery, a member of the Division of Adult Reconstructive Surgery at NYU Langone Orthopedics, and senior author of the study presented at AAOS. "The results indicate that not only are these technologies safe and effective, but they dramatically improve short-term outcomes of our patients having total knee surgery." The retrospective study by Dr. Meftah's group included a review of 16,009 NYU Langone surgeries from January 2017 to October 2023, comparing the use of computer-navigated and robotic surgical systems with conventional techniques in total knee arthroplasty. The results showed that length of stay was shorter and patients were discharged to their homes at a higher rate after either computer-navigated or robotic systems than they were after conventional methods. Additionally, perfect activity scores on post-operative discharge day zero were higher in robotic (30 percent) and navigated (19.5 percent) cases than the conventional group (8 percent). There were no differences in readmissions or revisions across any of the three surgical methods. Podium Presentation: Trimming the Risks: Weight Loss and its Effect on Obesity-Related Complications in Spine Fusion Surgery Although the benefits of weight reduction have been shown to improve overall health and satisfaction, the effect of preoperative weight loss on complications and outcomes after lumbar spinal fusion is not fully understood. Physicians in NYU Langone's Spine Center set out to evaluate the association of postoperative complications with significant weight loss prior to lumbar fusion surgery. "We wanted to understand if there are truly benefits to preoperative weight-loss programs ahead of spinal fusion surgeries, and found there were real differences," said Tina Raman, MD, study author and director of research for the Division of Spine Surgery at NYU Langone. "Our study confirmed a significant reduction in complication risk if patients lose weight before surgery. It's critical to have those conversations with patients and develop an effective plan leading up to surgery." In the study of 702 patients, including 362 with normal body mass index rates, 204 who were obese, and 136 who lost weight over an average of 1,896 days, significant differences were observed between the groups. Patients in the normal group had lower operative time, less blood loss, and shorter lengths of stay than patients who were obese, though there were no significant differences in those factors between the obese and weight loss groups. Deep surgical infections, however, were found to be significantly lower in the weight loss group (0 percent), compared with the group who were obese (3.45 percent). Podium Presentation: The Monitored Anesthesia Care–Soft Tissue Infiltration with Local Anesthesia (MAC–STILA) Technique Decreases Incidence of Short-Term Postoperative Altered Mental Status in Hip Fracture Patients Hip fractures are common injuries that have significant health impacts on patients, and altered mental status (AMS) from anesthesia is one of the most prevalent complications immediately following surgical repair. Those cognitive effects then have adverse impacts on outcomes, can delay rehabilitation, and increase costs for the hospital, insurance, and patient. Faculty set out to test an alternative approach to general anesthesia to see if AMS could be mitigated. "We want patients to be set up for the best recovery possible following surgery, so we looked at how to reduce altered mental status postoperatively," said Sanjit R. Konda, MD, an associate professor, a member of the Division of Trauma and Fracture Surgery, and senior author of the study presented at AAOS. "By using lighter sedation and adding local anesthetic at the hip-repair site, we saw a significant improvement in our patients after surgery." This technique, called monitored anesthesia care with soft-tissue infiltration with local anesthesia (MAC–STILA), pairs anesthesiologist-administered sedation with surgeon-administered local anesthetic applied directly on the surgical site. This alternative anesthesia approach can be used in hip fractures repaired with cannulated screws, sliding hip screws, and cephalomedullary nails. The study reviewed 1,076 procedures between October 2019 and November 2022 in which patients were given either MAC–STILA, general anesthesia (GA), or spinal anesthesia. The review found patients who had MAC–STILA had significantly lower odds of AMS in the short-term postoperative period compared with those who had GA. Additionally, MAC–STILA patients required significantly less narcotic medication up to 48 hours post-operatively compared to GA patients. American Orthopaedic Society of Sports Medicine Specialty Session: Patients with Bilateral ACL Reconstruction (ACLR) Have 3X the Rate of Posterior Tibial Slope Greater than 12-Degrees Compared to Unilateral ACLR: MRI and Radiographic Evaluation An increased posterior tibial slope (PTS)—a condition marked by a greater slope of the shin bone toward the back of the knee—can increase the risk of injury of the anterior cruciate ligament (ACL), the fibrous connective tissue in the knee that connects the shin bone to the thigh bone. Sports medicine physicians at NYU Langone Orthopedics will present findings on a study published in The American Journal of Sports Medicine that compares PTS values in patients who have undergone bilateral ACL reconstruction to those who had unilateral ACL reconstruction. "Understanding biomechanics and each patient's unique anatomy helps us to better manage their return to normal activity after surgery," said Laith M. Jazrawi, MD, chief of the Division of Sports Medicine. "Understanding the posterior tibial slope and the effect it has on the ACL can inform our approach to more individualized surgical repairs. We set out to determine if there is a much greater slope in patients who had bilateral ACL tears compared with patients who had a unilateral ACL tear." The retrospective compared radiography and magnetic resonance imaging (MRI) captured at NYU Langone among 53 patients who underwent unilateral ACL reconstruction and 53 patients who underwent bilateral ACL reconstruction between 2012 and 2020. The comparisons were matched between patients of similar age and body mass index and the same sex. Researchers found the rate of a radiographic PTS greater than 12 degrees was 2.4 times higher among patients who had bilateral ACL tears compared with those who had unilateral ACL tears. Additionally, when PTS measurement values on radiographs were compared with MRI, a negligible correlation was found between those two imaging modalities. Media Inquiries Marlene Naanes Phone: 929-923-3102 [email protected] Colin DeVries Phone: 212-404-3588 [email protected] SOURCE NYU Langone Health

SAN FRANCISCO, Feb. 12, 2024 /PRNewswire/ -- In adolescent athletes who underwent anterior cruciate ligament reconstruction (ACLR), the younger the athlete at the time of primary ACLR and an earlier return to sport (RTS) were significantly associated with an increased rate of secondary ACL injuries, according to new study presented at the 2024 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). The study, " Predictors of Anterior Cruciate Ligament Reinjury and Return to Sport in Adolescent Athletes," found that when the age of primary ACLR increases by one year, the rate of secondary ACL injury decreases by 29% and a one-month delay in RTS decreases the rate of a secondary ACL injury by 17%. "In our practice, we noticed we are seeing a larger prevalence of ACL injuries in this younger population, but we haven't seen literature that specifically looks at the high school age population," said Bhargavi Maheshwer, MD, lead author and third-year orthopaedic surgery resident at University Hospitals in Cleveland, Ohio. "Many of these athletes were returning for revisions or second opinions after having a retear or a contralateral ACL tear, so it is important to outline the trends behind the risk of having an ACL reinjury. Specifically, the variables that are associated with the higher risk of sustaining these injuries and what can we do from a patient education standpoint to address those variables." ACL injuries in adolescent athletes are increasing mainly due to the rise of younger athletes playing in competitive sports at an earlier age and an increased awareness of ACL injuries.[i],[ii] For younger athletes, an ACL injury can have a major impact. For example, there is significant downtime associated with an ACL tear, which may lead to mental health issues, they are 10 times more likely to develop early arthritis, and there is a 25-35% increased risk of experiencing a secondary ACL tear.[iii] Additionally, up to 14% of adolescents who undergo ACLR do not return to their previous level of play.[iv] The researchers sought to identify recent epidemiologic trends of ACL injuries and recurrent tear rates in high school athletes, and determine variables related to sustaining a secondary ACL injury. Using a prospectively maintained database from a single institution, the team retrospectively reviewed data for all patients under the age of 18 who underwent primary ACLR from 2015-2020. Patients were eligible if they were 13-18 years old, participated in a high school sport, and underwent evaluation and primary ACLR at a single institution. To be included, patients had to have a follow-up duration of six months or more and had not undergone a prior revision ACLR. Outcomes included postoperative complications, re-operations, time to RTS (defined as the number of months following ACLR until the patient was cleared to return to the sport by the operating surgeon), and time to retear or reinjury. Odd ratios were calculated for baseline patient characteristics and the association with the risk of retear. Multivariate Cox regression analysis was performed to identify the relationship between retear and potential risk factors. The results included: A total of 431 adolescent patients were included with a median follow up of over five years – 20.2% (87) sustained a secondary ACL injury and 79.8% (344) did not. Nine percent (39) of patients with a secondary ACL injury experienced a graft failure and 11.2% (48) had a contralateral ACL injury (ACL injury on the uninjured knee). Complication rates were low (n=22 6.1%), with 11 patients experiencing arthrofibrosis (3%), one patient (0.2%) with a superficial wound infection managed with antibiotics and one patient (0.2%) with deep infection that required operative irrigation and debridement. Patients with a secondary ACL injury were older than those who did not have another ACL tear (mean age at surgery 16.2 ± 1.3 years versus 15.6 ± 1.5 years, respectively, p=0.003). After adjusting for all variables, a younger age at primary ACLR and time to RTS were significantly associated with an increased rate of secondary ACL injury. "Nine months is the minimum that we consider it safe to return to sport following ACLR as a rapid return to sport puts you at greater risk of a recurrent injury," said James Everett Voos, MD, FAAOS, orthopaedic surgeon, chairman of orthopaedics at University Hospitals and head team physician for the Cleveland Browns. "For our younger athletes, we should take the time to ensure they are fully recovered and have had a chance to rehabilitate since they are often skeletally immature and still growing. As orthopaedic surgeons, we need to customize the treatment plan for each athlete as not all ACLs are the same, and counsel patients about their type of injury and when to return to the sport based on their rehabilitation and age." # # # 2024 AAOS Annual Meeting Disclosure Statement About the AAOS With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world's largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level to best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments and related musculoskeletal healthcare issues; and it leads the healthcare discussion on advancing quality. Follow the AAOS on Facebook, X, LinkedIn and Instagram. SOURCE American Academy of Orthopaedic Surgeons