ORCID Profile
0000-0002-2408-5307
Current Organisations
Kansas City University of Medicine and Biosciences
,
AZBSC Orthopedics
,
Arizona State University
,
Nottingham Trent University
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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.
Publisher: SAGE Publications
Date: 11-10-2018
Abstract: R lesions are characterized by disruption of the peripheral meniscocapsular attachments of the posterior horn of the medial meniscus. R repair performed at the time of anterior cruciate ligament reconstruction (ACLR) has been shown to improve knee biomechanics. The primary objectives of this study were to evaluate the incidence of and risk factors for r lesions among a large series of patients undergoing ACLR. Secondary objectives were to determine the reoperation rate for failure of r repair, defined by subsequent reoperations for partial medial meniscectomy. Case-control study Level of evidence, 3. Case series Level of evidence, 4. All patients underwent transnotch posteromedial compartment evaluation of the knee during ACLR. R repair was performed if a lesion was detected. Potentially important risk factors were analyzed for their association with r lesions. A secondary analysis of all patients who underwent r repair and had a minimum follow-up of 2 years was undertaken to determine the secondary partial meniscectomy rate for failed r repair. The overall incidence of r lesions in the study population was 23.9% (769 r lesions among 3214 patients). Multivariate analysis demonstrated that the presence of r lesions was significantly associated with the following risk factors: male sex, patients aged years, revision ACLR, chronic injuries, preoperative side-to-side laxity mm, and concomitant lateral meniscal tears. The secondary meniscectomy rate was 10.8% at a mean follow-up of 45.6 months (range, 24.2-66.2 months). Patients who underwent ACLR + anterolateral ligament reconstruction had a -fold reduction in the risk of reoperation for failure of r repair as compared with patients who underwent isolated ACLR (hazard ratio, 0.457 95% CI, 0.226-0.864 P = .021). There is a high incidence of r lesions among patients undergoing ACLR. The identification of important risk factors for r lesions should help raise an appropriate index of suspicion and prompt posteromedial compartment evaluation. The overall secondary partial meniscectomy rate after r repair is 10.8%. Anterolateral ligament reconstruction appears to confer a protective effect on the r repair performed at the time of ACLR and results in a significant reduction in secondary meniscectomy rates.
Arthrogenic muscle inhibition after ACL reconstruction: a scoping review of the efficacy of interventions
Publisher: BMJ
Date: 07-09-2018
DOI: 10.1136/BJSPORTS-2017-098401
Abstract: To determine whether reported therapeutic interventions for arthrogenic muscle inhibition (AMI) in patients with ACL injuries, following ACL reconstruction, or in laboratory studies of AMI, are effective in improving quadriceps activation failure when compared with standard therapy in control groups. A scoping review of the efficacy of interventions was conducted in accordance with the methodological framework of Arksey and O’Malley and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Search terms included ‘arthrogenic muscle inhibition’, ‘quadriceps activation following knee injuries’, ‘anterior cruciate’ or ‘knee’ combined with ‘quadriceps activation’, ‘quadriceps inhibition’, ‘corticomotor’, ‘arthrogenic’, ‘brain activation’ and ‘neuroplasticity’. Articles were evaluated for risk of bias using the PEDro (Physiotherapy Evidence Database) criteria. The overall quality of evidence for each intervention was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). PubMed, EMBASE and Cumulative Index to Nursing and Allied Health Literature databases. Isolated case reports and articles reporting outcomes in patients with chronic disease or major trauma were excluded. All other original research articles were included. 780 potential articles were identified. 20 met the inclusion criteria. These studies provided a moderate quality of evidence to support the efficacy of cryotherapy and physical exercises in the management of AMI. There was low-quality evidence for efficacy of neuromuscular electrical stimulation and transcutaneous electrical nerve stimulation, and very low-quality evidence for efficacy of ultrasound and vibration. This scoping review demonstrated moderate-quality evidence for the efficacy of cryotherapy and physical exercises in improving quadriceps activation failure after ACL injury and reconstruction. These therapeutic modalities are therefore recommended in the management of AMI.
Arthroscopic bone block stabilisation procedures for glenoid bone loss in anterior glenohumeral instability: A systematic review of clinical and radiological outcomes
Publisher: Elsevier BV
Date: 09-2021
Anterolateral Ligament Reconstruction Protects the Repaired Medial Meniscus: A Comparative Study of 383 Anterior Cruciate Ligament Reconstructions From the SANTI Study Group With a Minimum Follow-up o
Publisher: SAGE Publications
Date: 09-05-2018
Abstract: The prevalence of osteoarthritis after successful meniscal repair is significantly less than that after failed meniscal repair. To determine whether the addition of anterolateral ligament reconstruction (ALLR) confers a protective effect on medial meniscal repair performed at the time of anterior cruciate ligament reconstruction (ACLR). Cohort study Level of evidence, 3. Retrospective analysis of prospectively collected data was performed to include all patients who had undergone primary ACLR with concomitant posterior horn medial meniscal repair through a posteromedial portal between January 2013 and August 2015. ACLR autograft choice was bone–patellar tendon–bone, hamstring tendons (or quadrupled hamstring tendons), or quadrupled semitendinosus tendon graft with or without ALLR. At the end of the study period, all patients were contacted to determine if they had undergone reoperation. A Kaplan-Meier survival curve was plotted, and a Cox proportional hazards regression model was used to perform multivariate analysis. A total of 383 patients (mean ± SD age, 27.4 ± 9.2 years) were included with a mean follow-up of 37.4 months (range, 24-54.9 months): 194 patients underwent an isolated ACLR, and 189 underwent a combined ACLR + ALLR. At final follow-up, there was no significant difference between groups in postoperative side-to-side laxity (isolated ACLR group, 0.9 ± 0.9 mm [min to max, –1 to 3] ACLR + ALLR group, 0.8 ± 1.0 mm [min to max, –2 to 3] P = .2120) or Lysholm score (isolated ACLR group, 93.0 [95% CI, 91.3-94.7] ACLR + ALLR group, 93.7 [95% CI, 92.3-95.1] P = .556). Forty-three patients (11.2%) underwent reoperation for failure of the medial meniscal repair or a new tear. The survival rates of meniscal repair at 36 months were 91.2% (95% CI, 85.4%-94.8) in the ACLR + ALLR group and 83.8% (95% CI, 77.1%-88.7% P = .033) in the ACLR group. The probability of failure of medial meniscal repair was times lower in patients with ACLR + ALLR as compared with patients with isolated ACLR (hazard ratio, 0.443 95% CI, 0.218-0.866). No other prognosticators of meniscal repair failure were identified. Combined ACLR and ALLR is associated with a significantly lower rate of failure of medial meniscal repairs when compared with those performed at the time of isolated ACLR.
The popliteus tendon provides a safe and reliable location for all-inside meniscal repair device placement
Publisher: Springer Science and Business Media LLC
Date: 03-03-2018
DOI: 10.1007/S00167-018-4889-3
Abstract: Repairs of the posterior horn of the lateral meniscus can be technically challenging. In contrast to medial meniscus repairs, the capsule around the posterior segment attachment of the lateral meniscus is quite thin. This study evaluates the clinical results of an arthroscopic all-inside repair technique for unstable, vertical, lateral meniscus tears, using a suture repair placed directly into the popliteus tendon. A retrospective analysis of prospectively collected data from the SANTI database was performed. All patients who had undergone combined ACL reconstruction with lateral meniscus all-inside repair, using sutures placed in the popliteus tendon, between 2011 and 2015, were included. Patients were reviewed clinically at 1 and 2 years' follow-up. At final follow-up, all patients were contacted to identify if they underwent further surgery or had knee pain, locking or effusion. Symptomatic patients were recalled for clinical evaluation by a physician and Magnetic Resonance Imaging of the knee. Operative notes for those undergoing further surgery were reviewed and rates and type of re-operation, including for failed lateral meniscal repair were recorded. Two hundred patients (mean age 28.6 ± 10.2 years) with a mean follow-up of 45.5 ± 12.8 months (range 24.7-75.2) were included. The mean Subjective International Knee Documentation Committee (IKDC) at final follow-up was 85.0 ± 11.3. The post-operative mean side-to-side laxity measured at 1 year was 0.6 ± 1.0 mm. Twenty-six patients underwent re-operation (13%) at a mean follow-up of 14.8 ± 7.8 months. The ACL graft rupture rate was 5.0%. Other causes for re-operation included medial meniscus tear (2.5%), cyclops lesion (1.5%) and septic arthritis (0.5%). The lateral meniscus repair failure rate was 3.5%. No specific complications relating to placement of sutures in the popliteus tendon were identified. Arthroscopic all-inside repair of unstable, vertical, lateral meniscus tears using a suture placed in the popliteus tendon is a safe technique. It is associated with a very low failure rate with no specific complications. Level IV.
Effect of Meniscal Ramp Lesion Repair on Knee Kinematics, Bony Contact Forces, and In Situ Forces in the Anterior Cruciate Ligament: Letter to Editor
Publisher: SAGE Publications
Date: 31-01-2020
Anterolateral Ligament: Let's Stick to the Facts!
Publisher: Elsevier BV
Date: 08-2018
Related Organisations
Kansas City University Of Medicine And Biosciences
Location: United States of America
Nottingham Trent University
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
No related grants have been discovered for Adnan Saithna.