The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Darren L. Johnson - One of the best experts on this subject based on the ideXlab platform.
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Current Rehabilitation Concepts for Anterior Cruciate Ligament Surgery in Athletes.
Orthopedics, 2015Co-Authors: Chaitu S. Malempati, John Jurjans, Brian Noehren, Mary Lloyd Ireland, Darren L. JohnsonAbstract:The anterior cruciate Ligament is the most commonly disrupted Ligament in the knee in high-performance athletes. Most recently, advancements in surgical technique and graft fixation have enabled athletes to participate in early postoperative rehabilitation, focusing on range of motion and progressing to patellar mobilization, strengthening, and neuromuscular control. Several rehabilitation protocols exist with variations in specific exercises, progression through phases, and key components. The ultimate goal of rehabilitation is to return the athlete to preinjury performance level, including motion and strength, without injuring or elongating the graft. Each athlete is unique; thus, safe return to play should be individualized rather than follow a particular postoperative month or time line. This article provides an overview of the application and the scientific basis for formulating a rehabilitation protocol prior to and following anterior cruciate Ligament Surgery.
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Graft selection in anterior cruciate Ligament Surgery.
Orthopedics, 2010Co-Authors: Matthew R Poulsen, Darren L. JohnsonAbstract:The ideal graft for ACL Surgery should have similar anatomic and biomechanical characteristics to the native ACL, provide for strong initial fixation, allow for prompt biologic incorporation, and have minimal donor site morbidity for a particular athlete.
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Fixation devices in ACL Surgery: what do I need to know?
Orthopedics, 2005Co-Authors: Manuj C Singhal, Brandon S Fites, Darren L. JohnsonAbstract:Anterior cruciate Ligament Surgery has become a reliable and reproducible procedure resulting in patient satisfaction in >90% of cases.
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Tunnel Enlargement After Anterior Cruciate Ligament Surgery
The American journal of sports medicine, 2004Co-Authors: Timothy C. Wilson, Anthony Kantaras, Ahmet Ozgur Atay, Darren L. JohnsonAbstract:Bone tunnel enlargement has been reported after anterior cruciate Ligament (ACL) reconstruction Surgery. Although the long-term outcome of this phenomenon is not yet known, tunnel lysis or expansion may be clinically significant in revision Surgery because the enlarged tunnels may complicate graft placement and fixation. There any many proposed theories for tunnel lysis. The most accurate statement is that this condition has a multifactorial etiology. Mechanical and biological causes have been reported, and both contribute to enlarged graft tunnels. This article describes the multiple causes of bone tunnel enlargement after ACL Surgery. Future techniques and advances in primary ACL Surgery must seek to eliminate this phenomenon.
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Technical pitfalls of anterior cruciate Ligament Surgery.
Clinics in sports medicine, 1999Co-Authors: David Bealle, Darren L. JohnsonAbstract:Anterior cruciate Ligament (ACL) reconstruction is extremely common. Although the number of primary reconstructions is increasing, failures and revision procedures continue to occur at approximately the same frequency. ACL reconstruction is a technically difficult procedure, and many failures can be attributed to surgical error. This article addresses the causes for failure of primary ACL reconstruction that lie within the surgeon's control. Preoperative assessment, surgical technique, and rehabilitation are addressed.
Christopher D. Harner - One of the best experts on this subject based on the ideXlab platform.
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Revision Anterior Cruciate Ligament Surgery
Advanced Arthroscopy, 2001Co-Authors: Mark D. Miller, Christopher D. HarnerAbstract:Anterior cruciate Ligament (ACL) reconstruction has become one of the most popular orthopedic procedures in the United States.1 Although this operation is usually successful, failure rates can be as high as 25%.2 As the operation continues to gain popularity, the numbers of revision ACL reconstructions required will increase as well. It is imperative, therefore, for knee surgeons to be prepared to perform revision ACL Surgery. It is perhaps equally important for surgeons to have a variety of treatment options and techniques at their disposal.
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Loss of Motion Following ACL Reconstruction: A Second Look
Journal of Sport Rehabilitation, 1997Co-Authors: James J. Irrgang, Christopher D. Harner, Mark B. Silbey, Robbie DigiacomoAbstract:The purpose of this study was to determine the effects of preoperative, intraoperative, and postoperative intervention on the incidence of loss of motion (LOM) following ACL reconstruction. A retrospective review of patients undergoing ACL reconstruction between 1990 and 1991 was conducted to identify those with LOM. Factors potentially related to loss of motion were recorded. The results were compared to the findings of a similar group of patients who underwent ACL reconstruction between 1987 and 1989. In 1990 to 1991, less concomitant Ligament Surgery was performed, the incidence of loss of extension was significantly reduced, and the incidence of loss of flexion was significantly increased. It appears the risk for loss of extension can be minimized by delaying Surgery following acute injury, performing less concomitant Ligament Surgery, paying meticulous attention to notchplasty and anatomic placement of the graft, and placing early emphasis on restoration of full extension following Surgery.
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Revision anterior cruciate Ligament Surgery : Experience from Cincinnati : Failed anterior cruciate Ligament Surgery
Clinical Orthopaedics and Related Research, 1996Co-Authors: Darren L. Johnson, James J. Irrgang, Todd M. Swenson, Christopher D. HarnerAbstract:Twenty-five patients who underwent revision anterior cruciate Ligament reconstruction after failure of a previous intraarticular reconstruction were retrospectively reviewed. Before revision, all patients reported functional instability with sports or activities of daily living and exhibited increased anterior patholaxity on physical examination. Fresh frozen irradiated allograft tissue was used for all revisions. A comprehensive knee analysis using a subjective and objective system was done for all patients preoperatively and at the time of final followup. The mean age at revision Surgery was 25 years and average time from primary to revision Surgery was 30 months. Average length of followup was 28 months. The anteroposterior displacement was improved in all patients. Sixty-four percent of patients had less than 5 mm side to side difference on arthrometric testing. Eighty percent had either a Grade 0 or Grade 1 pivot shift. The average modified Cincinnati Knee Score was 68 with the results of 88% of patients rated abnormal by International Knee Documentation Committee guidelines. Seventy-six percent of patients were satisfied with their results and would elect to have revision Surgery again. These results show that patients having revision anterior cruciate Ligament reconstruction for a failed intraarticular reconstruction had improvement in their functional status compared with prerevision ; however, they did not achieve the same level of satisfactory results as primary anterior cruciate Ligament reconstruction.
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Technical considerations of revision anterior cruciate Ligament Surgery.
Clinical orthopaedics and related research, 1996Co-Authors: M. R. Safran, Christopher D. HarnerAbstract:Revision anterior cruciate Ligament Surgery will become more common as the number of primary anterior cruciate Ligament reconstructions increases. Also contributing to this increase are those patients who had anterior cruciate Ligament reconstructions increases. Also contributing to this increase ar
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Management of the Stiff Knee After Trauma and Ligament Reconstruction
Traumatic Disorders of the Knee, 1994Co-Authors: Christopher D. Harner, Mark D. Miller, James J. IrrgangAbstract:The “stiff knee,” which has been referred to as “arthrofibrosis,” “infrapatellar contracture syndrome,” “patella infera,” “ankylosis,” and various other names, is unfortunately an all too common complication of both fracture management and knee Ligament Surgery. The etiology of this difficult problem is as diverse as the terms used to describe it. It can be related to inadequate reduction or fixation of intraarticular fractures, prolonged traction or immobilization, infection, and Ligament Surgery (both intra- and extraarticular) to highlight only a few associated risk factors.
M. R. Safran - One of the best experts on this subject based on the ideXlab platform.
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Technical considerations of revision anterior cruciate Ligament Surgery : Failed anterior cruciate Ligament Surgery
Clinical Orthopaedics and Related Research, 1996Co-Authors: M. R. Safran, C. D. HarnerAbstract:Revision anterior cruciate Ligament Surgery will become more common as the number of primary anterior cruciate Ligament reconstructions increases. Also contributing to this increase are those patients who had anterior cruciate Ligament reconstruction using synthetic Ligaments and other nonanatomic techniques that are no longer used. Preoperative planning is imperative to a successful outcome. This begins with determining the primary, and often times secondary, mechanism of failure for each patient. The determination of the etiology of failure is the first step in a carefully constructed preoperative plan, including the type of revision, skin incision, graft removal, hardware removal, tunnel placement, graft selection, graft fixation, and rehabilitation. The precise preoperative plan should have enough flexibility to accommodate unanticipated findings in the operating room. Rehabilitation protocols must be designed specifically for the revision Surgery patient and be flexible enough to accommodate changes based on surgical findings and techniques. Finally, the importance of counseling the patient preoperatively regarding the potential results which, in general, are somewhat less satisfactory than with most primary reconstructions, must be emphasized. However, with proper planning, attention to detail, and adherence to basic principles of anterior cruciate Ligament reconstruction, revision anterior cruciate Ligament Surgery can provide a satisfying solution to difficult knee instability cases.
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Technical considerations of revision anterior cruciate Ligament Surgery.
Clinical orthopaedics and related research, 1996Co-Authors: M. R. Safran, Christopher D. HarnerAbstract:Revision anterior cruciate Ligament Surgery will become more common as the number of primary anterior cruciate Ligament reconstructions increases. Also contributing to this increase are those patients who had anterior cruciate Ligament reconstructions increases. Also contributing to this increase ar
Arndt-peter Schultz - One of the best experts on this subject based on the ideXlab platform.
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Functional outcome of septic arthritis after anterior cruciate Ligament Surgery.
International orthopaedics, 2014Co-Authors: Justus Gille, Ulf Gerlach, Ralf Oheim, Thorben Hintze, Bastian Himpe, Arndt-peter SchultzAbstract:Purpose Septic arthritis is a rare complication after cruciate Ligament Surgery. The lack of conclusive evidence makes it difficult to obtain a consensus concerning the best treatment option.
C. D. Harner - One of the best experts on this subject based on the ideXlab platform.
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Technical considerations of revision anterior cruciate Ligament Surgery : Failed anterior cruciate Ligament Surgery
Clinical Orthopaedics and Related Research, 1996Co-Authors: M. R. Safran, C. D. HarnerAbstract:Revision anterior cruciate Ligament Surgery will become more common as the number of primary anterior cruciate Ligament reconstructions increases. Also contributing to this increase are those patients who had anterior cruciate Ligament reconstruction using synthetic Ligaments and other nonanatomic techniques that are no longer used. Preoperative planning is imperative to a successful outcome. This begins with determining the primary, and often times secondary, mechanism of failure for each patient. The determination of the etiology of failure is the first step in a carefully constructed preoperative plan, including the type of revision, skin incision, graft removal, hardware removal, tunnel placement, graft selection, graft fixation, and rehabilitation. The precise preoperative plan should have enough flexibility to accommodate unanticipated findings in the operating room. Rehabilitation protocols must be designed specifically for the revision Surgery patient and be flexible enough to accommodate changes based on surgical findings and techniques. Finally, the importance of counseling the patient preoperatively regarding the potential results which, in general, are somewhat less satisfactory than with most primary reconstructions, must be emphasized. However, with proper planning, attention to detail, and adherence to basic principles of anterior cruciate Ligament reconstruction, revision anterior cruciate Ligament Surgery can provide a satisfying solution to difficult knee instability cases.