Anatomic double-bundle ACL reconstruction is significantly superior to conventional single-bundle ACL reconstruction and better than anatomic single-bundle reconstruction. Anatomic single-bundle reconstruction was superior to conventional single-bundle reconstruction. However, these differences are small and may not be clinically relevant.
Anatomic double-bundle reconstruction is not superior to anatomic single-bundle reconstruction when an individualized ACL reconstruction technique is used.
BackgroundAfter anterior cruciate ligament (ACL) reconstruction, formation of cortical sclerotic bone encircling the femoral and tibial tunnel is a part of intratunnel graft healing. During the physiological cascades of soft tissue healing and bone growth, cellular and hormonal factors play an important role. The purpose of this study was to non-invasively but quantitatively assess the effect of intraoperatively applied platelet-rich plasma (PRP) on the formation of cortical bone encircling the tibial tunnel.Patients and methodsIn fifty patients, standard arthroscopic ACL reconstructions were performed. The PRP group (n = 25) received a local application of PRP while the control group (n = 25) did not receive PRP. The proximal tibial tunnel was examined by MRI in the paraxial plane where the portion of the tibial tunnel wall circumference consisting of sclerotic cortical bone was assessed with testing occurring at one, two and a half and six months after surgery.ResultsAt one month after surgery, differences between the groups in the amount of cortical sclerotic bone encircling the tunnel were not significant (p = 0.928). At two and a half months, the sclerotic portion of the tunnel wall in the PRP group (36.2%) was significantly larger than in the control (22.5%) group (p = 0.004). At six months, the portion of sclerotic bone in the PRP group (67.1%) was also significantly larger than in the control (53.5%) group (p = 0.003).ConclusionsEnhanced cortical bone formation encircling the tibial tunnel at 2.5 and 6 months after ACL graft reconstruction results from locally applied platelet-rich plasma.
IntroductionThe first large outbreak of SARS-CoV-2 in Europe occurred in Northern Italy in February 2020. The relatively fast spread of the infection to Slovenia was expected, and preventive measures for its suppression were widely discussed.MethodsAn online questionnaire was designed to evaluate adherence to preventive measures and the extent to which the taking of preventive measures was associated with people’s anxiety level, psychological burden, their perceived vulnerability to disease, germ aversion and a number of demographic characteristics in the early stage of Covid-19 spread. The survey was active for 24 hours (13–14 March 2020). There were 12,307 responses and 7,764 questionnaires were completed in full.ResultsHigher preventive behaviour was found in individuals who experienced greater psychological distress, were more anxious, and expressed greater perceived infectability and germ aversion. Greater compliance with preventive behaviour was found among women, those sharing a household with people aged over 65, the elderly and those who knew somebody who had been infected. These groups also showed higher anxiety levels, which appeared to be significantly increased in general as a result of the specific situation. Quarantine was evaluated as the most efficient preventive measure, and was respected relatively strictly even before it became an officially announced protective measure.ConclusionThis research reveals a strong association between preventive behaviour and anxiety. Anxiety, together with social distancing, may affect physical and psychological health in the population in the long term. Other aspects of public health might therefore be influenced by the measures currently being enforced to prevent the spread of SARS-CoV-2.
A lack of information about disease in children can lead to erroneous views such as children believing that hospital admittance or the presence of a disease is a punishment for a perceived wrong. There has thus far been no standard tool available to measure children's illness conceptualizations from a Leventhalian framework. Three groups of children with eczema, asthma and eczema and asthma between the ages of 7 and 12 years of age were recruited. Children were given the Children's Illness Perception Questionnaire (CIPQ), a 26-item instrument adapted from the Illness Perception Questionnaire for adults. A Kuder - Richardson 20 test of reliability for dichotomous data was performed allowing an estimate of the internal consistency of the measurement scales. It can be seen that, for all three illness groups, internal consistency is acceptable for the timeline and consequences scale. The cure/control scale, however, was not internally consistent for any illness group. As health professionals, we need to develop the means to further understand how paediatric illness beliefs relate to specific disease types, age and psychosocial factors and the utility of this instrument is discussed within this context.
Long-term muscle weakness may increase the risk of knee reinjury after anterior cruciate ligament reconstruction (ACLR) and of osteoarthritis. The incidence of secondary injuries after ACLR and the predictive value of preoperative and postoperative limb symmetry index (LSI) and estimated preinjury capacity (EPIC) index were studied for predicting the risk of reinjury in a retrospective study. Sixty-three recreational and professional athletes after ACLR with hamstring autograft were followed for secondary injury in the period from 2012 to 2014, 5 years after ACLR. Peak torque values of knee extensor and flexor muscle strength of the involved and uninvolved limb were measured with an isokinetic dynamometer at 60 degrees per second before ACLR and 6 months after ACLR and were used to calculate LSI and EPIC index. The results suggest that the preoperative LSI and EPIC indexes predict a secondary ACL injury better than the postoperative LSI for extensor muscles which is often used as a criterion to determine the time for returning to normal sports activities. Individuals with secondary ACL injuries suffer greater loss of knee extensor muscle strength of the uninvolved limb between preoperative and postoperative ACLR testing compared to the individuals without secondary injury.
Background:A lack of information about disease in children can lead to erroneous views such as children believing that hospital admittance or the presence of a disease is a punishment for a perceived wrong. There has thus far been no standard tool available to measure children’s illness conceptualisations from a Leventhalian framework. Furthermore, research on children with eczema suggests significant effects on children’s psychological wellbeing and everyday activities but few studies have adequately obtained the views of children themselves. Patients and Methods: Children with eczema, children with asthma and healthy controls between 7 and 12 years of age were recruited. Children were given the Children’s Illness Perception Questionnaire (CIPQ), a new 26-item instrument adapted from the Illness Perception Questionnaire for adults and The Piers-Harris Children’s Self-concept Scale. Results: Results suggested that the children with eczema felt greater consequences as a result of their disease than those with asthma. Furthermore, as regards psychosocial morbidity, the children’s understanding of the consequences of their disease was more important than the presence or visibility of the condition. Conclusions: As health professionals, we need to develop the means to further understand how paediatric illness beliefs relate to specific disease types, age and psychosocial factors. The understanding of children’s illness beliefs is discussed within this context.
This work could have important implications for the quality of life of the child and for the parent-child relationship and these implications are considered.
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