Administrative claims databases have large samples and high generalizability. They have been used to evaluate associations of atypical femoral fractures with bisphosphonates. We developed and assessed accuracy of claims-based algorithms with hospital and physician diagnosis codes for these fractures. Medical records and radiology reports of all adults admitted at University ...

Bisphosphonates reduce fractures risk in patients with osteoporosis. A new pattern of fractures is now being noted in patients on prolonged bisphosphonate therapy. We report a case of an atypical femoral fracture with preceding pain and highlight the characteristics of these fractures.

In recent years, atypical femoral fractures and osteonecrosis of the jaw have emerged as potential complications of long-term bisphosphonate therapy; osteonecrosis of the jaw has also been reported in patients receiving high doses of denosumab. The pathophysiology of both conditions is poorly defined, and the underlying mechanisms are likely to ...

For over a decade, bisphosphonate administration has evolved and become the cornerstone of the prevention and treatment of fragility fractures. Millions of post-menopausal women have relied on, and continue to depend on, the long-acting, bone density-maintaining pharmaceutical drug to prevent low-energy fractures. In return, we have seen the number of ...

We investigated bone mineral density (BMD) and bone metabolism in female bipolar patients who were undergoing long-term treatment with valproate combined with a low-dose atypical antipsychotic. Nineteen premenopausal women with bipolar disorder who were treated with valproate combined with atypical antipsycho-tics for at least 2 years were evaluated. The BMD ...

Context: Atypical femoral fractures have rarely been reported in women taking bisphosphonates, but this is still a controversial issue. Data are derived mainly from observation studies because a post hoc analysis from a randomized clinical trial did not find any such association. Objective: The aim of this study was to ...

Atypical subtrochanteric femoral fractures have been identified as a potential complication of long-term bisphosphonate therapy for the treatment of osteoporosis. Patients with skeletal malignant involvement, who receive much higher cumulative doses of bisphosphonates than do patients with osteoporosis, may be at higher risk for the development of these fractures. A ...

Background: Antipsychotics are commonly used in the elderly to treat the behavioural symptoms of dementia. Randomized controlled trial data on the safety of antipsychotics are limited and little is known about the long-term effects of these medicines. Observational studies have investigated the risk of hip fracture and pneumonia associated with ...

We report the case of a 65-year-old man presented with polymyalgia rheumatica. After a week on corticosteroid (40 mg/d), pain was relieved rapidly. Bone scan, requested to precisely localize osteoarticular lesions, showed high uptake in the external aspect of the head of left femur. In the clinical setting, bone scan ...

Study Design: Case report and clinical discussion.Objective: Description of a rare case of hyperpneumatization of the skull base including the cervical spine with the atlas bone.Summary of Background Data: Initial imaging studies of physically traumatized patients consist of conventional radiographs. An atypical radiolucency is often misdiagnosed as a primary malignancy ...

This case describes a man with an unusual cause of an atypical subtrochanteric fracture, pycnodysostosis. This condition results from mutations involving the cathepsin K gene. New antiresorptive treatments for osteoporosis inhibit the cathepsin K enzyme in osteoclasts. Therefore, there should be vigilant monitoring for the development of long-term complications noted ...

Although the existence of atypical femoral fractures is well established and bisphosphonate therapy is thought to be a major risk factor, the underlying mechanisms are poorly understood. Epidemiological data show that atypical femoral fractures account for only a small proportion of diaphyseal subtrochanteric femoral fractures, being about 100 times less ...

The purpose of this study was to determine whether drilling the femoral tunnel when performing anterior cruciate ligament (ACL) reconstruction through the accessory medial portal, as opposed to drilling the tunnel transtibially, will lead to more frequent location of the anteromedial femoral tunnel within the anatomic anteromedial bundle insertion site. ...

The regeneration of ligaments following injury is a slow process compared to the healing of many other tissues and the underlying mechanisms remain unknown. The purpose of the study was to evaluate the proliferative potential of ligaments by assessing telomere length within three distinct parts of human anterior cruciate ligament ...

In patients with osteosarcoma several causative factors are implicated in the occurrence of osteoporosis, such as no weight-bearing, pre- and post-surgical immobilization, and neoadjuvant and adjuvant chemotherapy. Nevertheless, osteoporotic fractures are a rare complication in young patients. We report the case of a spontaneous greenstick fracture of the distal tibia ...

Bisphosphonates are the most widely prescribed medicines for the treatment of osteoporosis and have generally been regarded as well-tolerated and safe drugs. Since 2005, there have been numerous case reports about atypical fractures of the femur linked to long-term treatment of osteoporosis with bisphosphonates. Some attempts to characterize pathophysiology and ...

The purpose of this study was to describe a simple and modified technique for arthroscopic suture fixation in a 12-year-old boy who sustained a displaced type III intercondylar eminence of the tibial. The arthroscopic fixation was modified by using the Arthrex suture lasso device to place two nonabsorbable sutures into ...

The aim of this study is to evaluate the midterm results of using Ligament Advanced Reinforcement System (LARS) artificial ligament for augmentation of the short (<15cm length) and small-sized (3-4mm) diameter for the gracilis and (4-5mm) for the semitendinosus harvested hamstring tendons in anterior cruciate ligament (ACL) reconstruction, and to ...

Fibroblasts isolated from skin and from anterior cruciate ligament (ACL) secrete type I and type III collagens in vivo and in vitro. However, it is much easier and practical to obtain a small skin biopsy than an ACL sample to isolate fibroblasts for tissue engineering applications. Various tissue engineering strategies ...

A partial tear of the anterior cruciate ligament is a frequent pattern of ACL injury, observed in 10 to 27% of isolated ACL lesions. There are three reasons to preserve these remnants: biomechanical, vascular and proprioceptive advantages for the patient. Good quality fibers work as graft protection during the healing ...

To the Editor: In their article on treating acute tears in the anterior cruciate ligament (ACL), Frobell et al. (July 22 issue)(1) conclude that early ACL reconstruction is not superior to a strategy of initial rehabilitation with delayed reconstruction. However, the primary outcome in the trial was a total score ...

We investigated knee kinematics during simulated weight-bearing flexion and determined the effect of 3 different parameters of external tibial loading on the kinematics of the anterior cruciate ligament (ACL)-intact and ACL-deficient knee. Ten human knee specimens were mounted on a dynamic knee simulator, and weight-bearing muscle-loaded knee flexions were simulated ...

The purpose of this study was to investigate the relation between knee functionality and posterior tibial slope in anterior cruciate ligament (ACL)-deficient and ACL-reconstructed patients. Patients with isolated ACL injuries on the surgical waiting list and patients who underwent ACL reconstruction with bone-patellar tendon-bone grafts between 18 and 24 months ...

The purpose of this study was to objectively evaluate the anatomic and biomechanical outcomes of anterior cruciate ligament (ACL) reconstruction with transtibial versus anteromedial portal drilling of the femoral tunnel. Ten human cadaveric knees (5 matched pairs) without ligament injury or pre-existing arthritis underwent ACL reconstruction by either a transtibial ...

Several researchers including our group have shown that knee joint biomechanics are impaired after anterior cruciate ligament (ACL) injury, in terms of kinematics and neuromuscular control. Current ACL reconstruction techniques do not seem to fully restore these adaptations. Our research has demonstrated that after ACL reconstruction, excessive tibial rotation is ...

Harvest of the central one-third of the patella tendon (PT) is routinely performed for anterior cruciate ligament reconstruction (ACLR). Patella infera may ensue. In this study we unilaterally resected the central one-third of the PT in 20 sheep, without reconstructing or defunctionalizing the native ACL, and examined the effects at ...

The purpose of this study was to compare anterior cruciate ligament (ACL) regeneration between animal groups subjected to intra-articular injection of fresh whole bone marrow cells (BMCs), cultured mesenchymal stem cells (MSCs), or saline. Partially transected ACLs in Fischer 344/Nslc rats were prepared, followed by injection of BMCs, MSCs, or ...

To explore the effect of different posterior-inferior tibial slope (PITS) angles on ACL injury at non-contact sports, knee laxity and the need for ACL reconstruction. One hundred patients with an acute, arthroscopically verified total ACL rupture were followed prospectively with the intention of treating the injury without reconstruction. Knee laxity ...

There are an estimated 80,000 to 100,000 anterior cruciate ligament (ACL) repairs in the United States each year. Most ACL tears occur from noncontact injuries. Women experience ACL tears up to nine times more often than men. Evaluation of the ACL should be performed immediately after an injury if possible, ...

Biological integration of the tendon graft is a crucial prerequisite for successful ACL reconstruction. Histological studies showed that the human ACL remnants contain a cellular capacity for healing potential. The goal of this technical note is to describe an ACL reconstruction technique, using ACL remnants as a biological sleeve for ...

The increase in anterior laxity and slippage is greater with metal interference screw fixation of a hamstring anterior cruciate ligament (ACL) graft than a bone-patellar tendon-bone graft. When slippage-resistant fixation is used with a soft tissue graft, early recovery of function does not result in a clinically important increase in ...

Several techniques have been described for reconstruction of the medial patellofemoral ligament (MPFL). The anatomical insertion of the MPFL has been defined; however, there are no reports describing the accuracy of femoral graft positioning assessed postoperatively. To analyze our femoral tunnel positioning for MPFL reconstruction in correlation with our clinical ...

Tendon stiffness may be involved in limiting peak musculoskeletal forces and thus may constitute an upper limit for bone strength. The patellar tendon bone (PTB) graft, which is harvested from the patellar tendon during surgical reconstruction of the anterior cruciate ligament (ACL), is an ideal scenario to test this hypothesis. ...

To compare the biomechanical properties of the EndoButton Direct (Smith & Nephew, Andover, MA) with the EndoButton CL (Smith & Nephew) using 2 different drilling techniques. Only the femoral side (and not the tibial side) of the graft fixation complex (bone-fixation device-anterior cruciate ligament [ACL] graft) was examined in this ...

In this study we evaluated the role of the anterior cruciate ligament (ACL) and its secondary restraint in controlling knee stability using a navigation system. The purpose of this study was to evaluate the kinematics of the knee in different conditions of instability: ACL intact, after transection of the posterolateral ...

Use of novel tissue engineering approaches to heal an injured anterior cruciate ligament (ACL) requires suture repair and/or augmentation to provide joint stability. We evaluated the effects of the location of suture augmentation at the femur and tibia in terms of joint stability using a goat model. Eight goat stifle ...

The purpose was to measure anterior cruciate ligament (ACL) femoral tunnel lengths comparing anteromedial (AM) portal and outside-in techniques. ACL femoral guide pins were drilled into 12 cadaveric knees through the AM portal technique and then the outside-in technique in each specimen. Pin intraosseous distance was measured in millimeters by ...

Anterior cruciate ligament (ACL) injuries are common in athletic and physically active populations, and can result in significant functional disability. Female athletes in particular have been found to be at a relatively high risk for noncontact ACL injuries. Many risk factors, both intrinsic and extrinsic, have been identified. Although some ...

This study evaluated and compared the intraoperative stabilities using the low and high femoral tunnel techniques in ACL reconstruction. Seventy patients who underwent ACL reconstruction were equally allocated to low or high femoral tunnel groups (35 in the low femoral tunnel group and 35 in the high femoral tunnel group) ...

A high incidence of anterior cruciate ligament (ACL) injuries related to sports activities has been reported; however, the injury situation of ACL injury in badminton has not been elucidated. This study investigated the mechanism of ACL injury in badminton using a questionnaire. Information on injury mechanism was gathered from interviews ...

The purpose of this study was to evaluate the initial biomechanical properties of a fan-folded, single-loop construct of fan-folded fascia lata allograft in comparison to other graft tissues currently being used for anterior cruciate ligament (ACL) reconstruction. Eighteen fascia lata specimens were harvested from 11 donors and fan folded through ...

The objective of this study was to evaluate the effectiveness of hamstring (HT) autografts versus bone-patellar tendon-bone (BPTB) autografts for reconstruction of the anterior cruciate ligament (ACL). We searched the Cochrane Library, MEDLINE, EMBASE and the Chinese Biomedicine Database (CBM) for published randomised clinical trials (RCTs) relevant to ACL reconstruction ...

Anterior cruciate ligament reconstruction using autologous hamstring tendons is an established surgical procedure but some grafts fail due to poor fixation. This study compared the fixation of a new ACL graft fixation device (the EZ KneeSpan) to conventional soft-tissue threaded titanium interference screws (IS). The EZ device was designed to ...

Failure to diagnose injury to the posterolateral structures has been found to increase the forces experienced by the anterior cruciate ligament (ACL) and ACL grafts which may cause their subsequent failure. An isolated injury to the popliteus complex (PC) consisting of the popliteus tendon and popliteofibular ligament is not uncommon. ...

Medial patellofemoral ligament (MPFL) reconstruction has been recognized as a useful treatment method for patella instability. However, the optimal fixation site has not been well investigated, and few reports have examined intraoperative graft length change. The purpose of the study is to evaluate the intraoperative graft length change and femoral ...

Several double-bundle anterior cruciate ligament (ACL) reconstruction procedures were reported in the 1980s and 1990s. However, no significant differences were found in the clinical results between these double-bundle procedures and single-bundle procedures because the double-bundle procedures appeared to reconstruct only the anteromedial bundle with 2 bundles. In the early 2000s, ...

Although intrinsic and extrinsic risk factors for anterior cruciate ligament (ACL) injury have been explored extensively, the factors surrounding the inciting event and the biomechanical mechanisms underlying ACL injury remain elusive. This systematic review summarizes all the relevant data and clarifies the strengths and weaknesses of the literature regarding ACL ...

Significant advances have recently been made in understanding the mechanisms involved in noncontact anterior cruciate ligament (ACL) injury. Most ACL injuries involve minimal to no contact. Female athletes sustain a two- to eightfold greater rate of injury than do their male counterparts. Recent videotape analyses demonstrate significant differences in average ...

This systematic review was performed to improve our understanding of the current evidence regarding the influence of anterior cruciate ligament (ACL) injury and reconstruction on involved lower extremity apparent bone mineral density, bone content, or bone area mass (bone integrity). Two independent reviewers performed a Medline search from 1966 to ...

The objective of this study was to investigate the accurate AM and PL tunnel positions in an anatomical double-bundle ACL reconstruction using human cadaver knees with an intact ACL. Fifteen fresh-frozen non-paired adult human knees with a median age of 60 were used. AM and PL bundles were identified by ...