A Prospective Study of the Association Between Bone Contusion and Intra-articular Injuries Associated With Acute Anterior Cruciate Ligament Tear

Bisson, Leslie J.; Kluczynski, Melissa A.; Hagstrom, Lindsey S.; Marzo, John M.

doi:10.1177/0363546513490649

Cited by 72 publications

(108 citation statements)

References 18 publications

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“…Another explanation may be that a high-energy mechanism or injury is often involved in ramp lesions. 5 Other risks factors previously reported in the literature, but not evaluated in the present study, were a complete rupture versus partial 36 and a higher medial tibial slope. 39 The importance of clearly defining risk factors is in aiding surgeons to hold an appropriate index of suspicion for ramp lesions, prompt them to perform a posteromedial compartment evaluation, and identify and repair injuries in order to restore knee stability.…”

Section: Risk Factors For Ramp Lesionsmentioning

confidence: 47%

Epidemiological Evaluation of Meniscal Ramp Lesions in 3214 Anterior Cruciate Ligament–Injured Knees From the SANTI Study Group Database: A Risk Factor Analysis and Study of Secondary Meniscectomy Rates Following 769 Ramp Repairs

et al. 2018

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Background: Ramp lesions are characterized by disruption of the peripheral meniscocapsular attachments of the posterior horn of the medial meniscus. Ramp repair performed at the time of ACL reconstruction has been shown to improve knee biomechanics. Hypothesis/Purpose: Primary objectives of this study were to evaluate the incidence and risk factors for ramp lesions in a large series of patients undergoing ACL reconstruction, Secondary objectives were to determine the re-operation rate for failure of ramp repair, defined by subsequent re-operations for partial medial meniscectomy Study Design: Case series Methods: All patients underwent trans-notch posteromedial compartment evaluation of the knee during ACL reconstruction. Ramp repair was performed if a lesion was detected. Potentially important risk factors were analyzed for their association with ramp lesions. A secondary analysis of all patients who underwent ramp repair and had a minimum follow-up of two years was undertaken in order to determine the secondary partial meniscectomy rate for failed ramp repair. Results: The overall incidence of ramp lesions in the study population was 23.9% (769 ramp lesions in 3214 patients). Multivariate analysis demonstrated that the presence of ramp lesions was significantly associated with the following risk factors: male gender, patients aged under 30 years, revision ACLR, chronic injuries, pre-operative side-to-side laxity >6 mm and the presence of concomitant lateral meniscus tears. The secondary meniscectomy rate was 10.8% at a mean follow up of 45.6 months (24.2-66.2). Patients who underwent ACLR + ALLR had a greater than 2-fold reduction in the risk of reoperation for failure of ramp repair as compared with patients who underwent isolated ACLR (hazard ratio, 0.457; 95%CI, 0.226-0.864; P = .021) 3 Conclusion: There is a high incidence of ramp lesions in patients undergoing ACLR. The identification of important risk factors for ramp lesions in this study in an individual patient should help raise an appropriate index of suspicion and prompt posteromedial compartment evaluation. The overall secondary partial meniscectomy rate after ramp repair is 10.8%. Anterolateral ligament reconstruction appears to confer a protective effect on the ramp repair performed at the time of ACLR and results in a significant reduction in secondary meniscectomy rates.

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Section: Risk Factors For Ramp Lesionsmentioning

confidence: 47%

Epidemiological Evaluation of Meniscal Ramp Lesions in 3214 Anterior Cruciate Ligament–Injured Knees From the SANTI Study Group Database: A Risk Factor Analysis and Study of Secondary Meniscectomy Rates Following 769 Ramp Repairs

et al. 2018

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“…Even early pattern-based methods are only slightly worse than machine learning approaches [28,45], although those did not fully leverage advances which the NLP community has made especially in terms of telling apart “good” patterns from bad ones [46,47]. Many difficult false positives turned out to be misinterpreted linguistic constructs like enumerations and coreferences.…”

Section: Discussionmentioning

confidence: 99%

A detailed error analysis of 13 kernel methods for protein-protein interaction extraction

et al. 2013

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BackgroundKernel-based classification is the current state-of-the-art for extracting pairs of interacting proteins (PPIs) from free text. Various proposals have been put forward, which diverge especially in the specific kernel function, the type of input representation, and the feature sets. These proposals are regularly compared to each other regarding their overall performance on different gold standard corpora, but little is known about their respective performance on the instance level.ResultsWe report on a detailed analysis of the shared characteristics and the differences between 13 current methods using five PPI corpora. We identified a large number of rather difficult (misclassified by most methods) and easy (correctly classified by most methods) PPIs. We show that kernels using the same input representation perform similarly on these pairs and that building ensembles using dissimilar kernels leads to significant performance gain. However, our analysis also reveals that characteristics shared between difficult pairs are few, which lowers the hope that new methods, if built along the same line as current ones, will deliver breakthroughs in extraction performance.ConclusionsOur experiments show that current methods do not seem to do very well in capturing the shared characteristics of positive PPI pairs, which must also be attributed to the heterogeneity of the (still very few) available corpora. Our analysis suggests that performance improvements shall be sought after rather in novel feature sets than in novel kernel functions.

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“…(62) Additionally, subchondral bone lesions, or bone bruising, have been reported to occur in greater than 80% of patients with a complete ACL rupture in the acute phase (63,64) and have been associated with meniscal tears. (65) Such pathologies associated with ACL tear and reconstruction reduce the load bearing capacity of the tibiofemoral joint. However, equally the longer the muscle is inactive the more likely it is to atrophy (43) and be unable to produce the forces required to reduce the shearing and torsional strains associated with unpredicted changes of direction.…”

Section: Why Are Heavy Loads Contraindicated?mentioning

confidence: 99%

Blood Flow Restriction Training in Rehabilitation Following Anterior Cruciate Ligament Reconstructive Surgery: A Review

Hughes¹,

Rosenblatt

Paton

et al. 2018

Techniques in Orthopaedics

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Anterior cruciate ligament (ACL) rupture is a highly prevalent orthopaedic injury, resulting in substantial skeletal muscle atrophy due to changes in muscle protein balance and satellite cell abundance. Neural activation problems also contribute to strength loss, impacting upon a patients' physical function and rehabilitative capacity. Heavy loads typically required for muscle hypertrophy and strength adaptations are contraindicated due to graft strain and concomitant cartilage, meniscal and bone pathologies associated with ACL reconstruction. Strength of the quadriceps is a fundamental component for the ability to reduce shearing and torsional strains on the ACL with ground contact, and forms a critical component of ACL rehabilitation. Given the dangers of early post-operative heavy-loading, low-load blood flow restriction (BFR) training may provide an alternative rehabilitation tool for practitioners. Passive BFR can attenuate early muscle atrophy and strength loss, and may be more effective with the addition of novel, complementary therapies such as neuromuscular electrical stimulation. Upon ambulation, aerobic and resistance exercise with BFR can stimulate muscle hypertrophy and strength adaptations and resolve activation problems. This may occur through increasing muscle protein synthesis and satellite cell proliferation, decreasing muscle protein breakdown and improving muscle activation via altered recruitment patterns. Thus, BFR training may provide an effective rehabilitation tool that does not place heavy loads and force through the tibiofemoral joint. This may reduce the risk of damaging the graft, cartilage, meniscus or other intra-articular structures, providing thorough screening prior to use is followed by correct, evidenceinformed application.

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A Prospective Study of the Association Between Bone Contusion and Intra-articular Injuries Associated With Acute Anterior Cruciate Ligament Tear

Abstract: Bone bruising is more common and severe in young men, and lateral bone bruising is associated with lateral meniscal tears. Medial meniscal tears are associated with increased severity of LTP bruising.

Cited by 72 publications

References 18 publications

Epidemiological Evaluation of Meniscal Ramp Lesions in 3214 Anterior Cruciate Ligament–Injured Knees From the SANTI Study Group Database: A Risk Factor Analysis and Study of Secondary Meniscectomy Rates Following 769 Ramp Repairs

Epidemiological Evaluation of Meniscal Ramp Lesions in 3214 Anterior Cruciate Ligament–Injured Knees From the SANTI Study Group Database: A Risk Factor Analysis and Study of Secondary Meniscectomy Rates Following 769 Ramp Repairs

A detailed error analysis of 13 kernel methods for protein-protein interaction extraction

Blood Flow Restriction Training in Rehabilitation Following Anterior Cruciate Ligament Reconstructive Surgery: A Review

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