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2012

Arthroscopically Pertinent Anatomy of the Anterolateral and Posteromedial Bundles of the Posterior Cruciate Ligament

The clock-face method to identify the femoral posterior cruciate ligament (PCL) attachment has poor accuracy and reproducibility. Measurements of clinically relevant anatomic structures would provide more useful surgical guidance. The purpose of this study was to describe the attachments of the anterolateral and posteromedial bundles of the PCL relative to relevant landmarks to assist with arthroscopic anatomic PCL reconstructions.  During this study, dissections were performed on twenty non-paired fresh-frozen cadaveric knees. Clinical relevance:  The results of the present study can assist with more anatomic tunnel placement during single and double-bundle PCL reconstructions. The results also suggest that two reconstruction tunnels are needed to reconstruct the broad femoral attachment, whereas one reconstruction tunnel should be investigated further for the compact tibial attachment. 


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Tekscan Pressure Sensor Output Changes in the Presence of Liquid Exposure

The purpose of the study was to evaluate the load output of a pressure sensor in the presence of liquid saturation in a controlled environment. We hypothesized that a calibrated pressure sensor would provide diminishing load outputs over time in controlled environments of both humidified air and while submerged in saline and the sensors would reach a steady state output once saturated. A consistent compressive load was repeatedly applied to pressure sensors over time with a tensile testing machine. All sensors were initially calibrated in a dry environment and were tested in three groups: humid air, submerged in 0.9% saline solution, and dry. Because outcomes in biomedical research can affect clinical practices and treatments, the diminishing load output of the sensor in the presence of liquids should be accounted for. We recommend soaking sensors for more than 48 hr prior to testing in a moist environment. 


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Giphart Accuracy of a Contour-Based BiPlane Fluoroscopy Technique

While measuring knee motion in all six degrees of freedom is important for understanding and treating orthopaedic knee pathologies, traditional motion capture techniques lack the required accuracy. A variety of model-based biplane fluoroscopy techniques have been developed with sub-millimeter accuracy. However, no studies have statistically evaluated the consistency of the accuracy across motions of varying intensity or between degrees of freedom. Therefore, this study evaluated the bias and precision of a contour-based tracking technique by comparing it to a marker-based method (gold standard) during three movements with increasing intensity. This study found that the contour-based technique demonstrated sub-millimeter and sub-degree accuracy, indicating it is a highly accurate tool for measuring complex three dimensional knee movements of any intensity. 

Anatomic Suture Anchor Versus Brostrom Technique

This manuscript was co-written with our foot and ankle team to define the best manner to perform a lateral ankle ligament reconstruction.  In this study, we attempted to define whether a suture anchor at the fibula or talus best restores the native strength of the anterior talofibular ligament.  We found that both a standard Brostrom repair versus a suture anchor repair did not have any significant difference, and that the rehabilitation after the lateral ankle ligament repair is very important to be followed precisely so that the repairs heal sufficiently well for improved patient function. 

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Recruitment and Activity of the Pectineus and Piriformis Muscles

This study found that the pectineus and piriformis muscles are important for postoperative hip arthroscopy rehabilitation.  Specific exercises were defined, which will give use during the early phases of rehabilitation, to improve the function of these muscles. 

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