Search

Your search keyword '"Kramer, Dennis"' showing total 560 results
Start Over Author "Kramer, Dennis"

Refine your results

more »

more »

more »

more »

more »
560 results on '"Kramer, Dennis"'

102. Contributors

Author

Abeles, Aryeh M., primary, Aglietti, Paolo, additional, Ali, Azhar A., additional, Amendola, Annunziato, additional, Anderson, Allen F., additional, Anderson, Christian Noel, additional, Archibald, Jason D., additional, Arendt, Elizabeth, additional, Argenson, Jean-Noël, additional, Austin, Amy F., additional, Bach, Bernard R., additional, Backstein, David, additional, Baer, Geoffrey S., additional, Bajaj, Sarvottam, additional, Baldini, Andrea, additional, Baldwin, Mark A., additional, Barber-Westin, Sue, additional, Barker, Joseph, additional, Beauchamp, Christopher P., additional, Bédard, Martin, additional, Berend, Keith R., additional, Berger, Richard A., additional, Bernasek, Thomas, additional, Berry, Daniel J., additional, Bert, Jack M., additional, Bonner, Kevin F., additional, Brekke, Adam C., additional, Briggs, Karen K., additional, Brockett, Claire L., additional, Brooks, Michael K., additional, Browne, James A., additional, Bryant, Brandon J., additional, Burak, Jarett S., additional, Burge, Alissa, additional, Bush-Joseph, Charles, additional, Buvanendran, Asokumar, additional, Callaghan, John, additional, Carter, Tom R., additional, Chen, Eli, additional, Chhabra, Anikar, additional, Chu, Constance R., additional, Clark, Randy, additional, Clarke, Henry D., additional, Cohen, David E., additional, Cole, Brian J., additional, Coon, Thomas M., additional, Currier, John H., additional, Cushner, Fred D., additional, Dahm, Diane L., additional, Damron, Timothy A., additional, DeAngelis, Joseph P., additional, Deasy, Bridget M., additional, DeJour, David, additional, Della Valle, Craig J., additional, Dellon, A. Lee, additional, Demey, Guillaume, additional, Dennis, Douglas A., additional, Deutsch, Ezra, additional, Dickey, Ian D., additional, Diduch, David R., additional, Easley, Mark E., additional, Economopoulos, Kostas, additional, Engh, Gerard A., additional, Fanelli, Gregory C., additional, Farr, Jack, additional, Farrell, Christopher M., additional, Fehring, Thomas K., additional, Feller, Julian, additional, Finnoff, Jonathan T., additional, Fisher, John, additional, Fitz, Wolfgang, additional, Fitzpatrick, Clare K., additional, Fletcher, John P., additional, Flynn, John M., additional, Franks, Andrew G., additional, Friedman, Richard J., additional, Friel, Nicole A., additional, Fu, Freddie H., additional, Fulkerson, John P., additional, Fullick, Robert Kyle, additional, Ganley, Theodore J., additional, Garbuz, Donald S., additional, Gharaibeh, Burhan, additional, Gill, Thomas J., additional, Goddard, Maria S., additional, Gomoll, Andreas, additional, Gonzalez, Carlos, additional, Gooding, Christopher R., additional, Grumet, Robert C., additional, Gwathmey, F. Winston, additional, Haas, Steve, additional, Hafez, Mahmoud, additional, Haidukewych, George J., additional, Hajnik, Christopher A., additional, Hanssen, Arlen D., additional, Harner, Christopher D., additional, Hart, Joseph M., additional, Healy, William L., additional, Heeckt, Peter F., additional, Henry, Sarah E., additional, Heyworth, Benton E., additional, Hinton, Richard Y., additional, Hofmann, Aaron A., additional, Hofmann, Siegfried, additional, Holt, Ginger E., additional, Horlocker, Terese T., additional, Howell, Stephen M., additional, Huard, Johnny, additional, Hui, Catherine, additional, Hulet, Christophe, additional, Hull, Maury L., additional, Hungerford, Marc W., additional, Infante, Anthony F., additional, Insall, John N., additional, Jacofsky, David J., additional, Jarvis, James G., additional, Jennings, Louise, additional, Johnston, Charles E., additional, Jonna, V. Karthik, additional, Keller, Thomas, additional, Kesselman, Donna R., additional, Kessler, Craig, additional, Khakharia, Saurabh, additional, Khanuja, Harpal S., additional, Kim, Raymond H., additional, Kim, Sung Jae, additional, Kissin, Yair D., additional, Klingele, Kevin, additional, Kocher, Mininder S., additional, Komistek, Richard D., additional, Konin, Gabrielle P., additional, Kopp, Sandra L., additional, Kopydlowski, Nathan, additional, Kramer, Dennis, additional, Kuenze, Christopher M., additional, Lachiewicz, Paul F., additional, Lang, Jason E., additional, Langford, Joshua R., additional, LaPrade, Robert F., additional, Laz, Peter J., additional, Leidl, Matthew, additional, Leone, James M., additional, Leszko, Filip, additional, Levi, David, additional, Levi, Gabriel, additional, Lewis, Randall J., additional, Lind, Martin, additional, Lindvall, Eric M., additional, Lionberger, David R., additional, Liporace, Frank A., additional, Logan, Martin, additional, Lombardi, Adolph V., additional, Long, William J., additional, Lonner, Jess H., additional, Lustig, Sébastien, additional, Lyons, Steven, additional, Maak, Travis G., additional, Macalena, Jeffrey A., additional, Madoff, Samuel D., additional, Maeno, Shinichi, additional, Magnussen, Robert A., additional, Maher, Suzanne A., additional, Mahfouz, Mohamed R., additional, Mai, Sabine, additional, Marinello, Patrick G., additional, Mason, J. Bohannon, additional, Masri, Bassam A., additional, Masur, Henry, additional, Math, Kevin R., additional, Mather, Richard C., additional, Mathis, Kenneth B., additional, Matsuda, Shuichi, additional, McCandless, Jeremy, additional, McClure, Kristen E., additional, Meneghini, R. Michael, additional, Miller, Mark, additional, Mintz, Douglas, additional, Mont, Michael A., additional, Moorman, Claude T., additional, Morris, Michael J., additional, Morrison, William B., additional, Morse, Kenneth R., additional, Mueller, John Kyle P., additional, Muellner, Thomas, additional, Murray, David, additional, Musahl, Volker, additional, Neel, Michael D., additional, Nelson, Joshua, additional, Nett, Michael P., additional, Neyret, Philippe, additional, Noble, Philip C., additional, Noyes, Frank R., additional, O’Connor, Mary I., additional, Oetgen, Matthew E., additional, Pagnano, Mark W., additional, Palestro, Christopher J., additional, Parratte, Sebastien, additional, Parsley, Brian S., additional, Patil, Nilesh, additional, Pedersen, Henrik B., additional, Peterson, Lars, additional, Pillinger, Michael H., additional, Pinczewski, Leo, additional, Post, William R., additional, Rachala, Sridhar R., additional, Radnay, Craig S., additional, Rana, Adam J., additional, Randall, R. Lor, additional, Reiffel, Robert S., additional, Ries, Michael D., additional, Robinson, Samuel P., additional, Rodeo, Scott A., additional, Rodkey, William G., additional, Rodriquez, Jose, additional, Roehrig, Gregory J., additional, Rosenberg, Aaron G., additional, Rosenthal, Pamela B., additional, Rullkoetter, Paul J., additional, Saggin, Paulo R.F., additional, Salmon, Lucy, additional, Sanders, Roy, additional, Schenck, Robert C., additional, Schindler, Oliver S., additional, Schreiber, Verena M., additional, Scott, Richard D., additional, Scott, Susan Craig, additional, Scott, W. Norman, additional, Scuderi, Giles R., additional, Seidenstein, Ari D., additional, Sekiya, Jon K., additional, Servien, Elvire, additional, Severson, Erik P., additional, Sgaglione, Nicholas A., additional, Sharma, Adrija, additional, Sherman, Seth L., additional, Shin, Michael S., additional, Siebert, Werner E., additional, Sierra, Rafael J., additional, Sikes, C. Van, additional, Skaggs, David L., additional, Smith, Gideon P., additional, Solomon, Gary E., additional, Spindler, Kurt P., additional, Spitzer, Andrew I., additional, Springer, Bryan D., additional, Steadman, J. Richard, additional, Stets, Kelly, additional, Stevens, Anna L., additional, Stiehl, James B., additional, Strauss, Eric J., additional, Stuart, Michael, additional, Stulberg, S. David, additional, Tannenbaum, Eric, additional, Taylor, Dean C., additional, Templeton, Kimberly, additional, Thompson, Stephen R., additional, Thornhill, Thomas, additional, Treme, Gehron, additional, Tria, Alfred J., additional, Turman, Kimberly A., additional, Uhthoff, Hans K., additional, Unger, Anthony S., additional, Vail, Thomas Parker, additional, Van Citters, Douglas W., additional, Van Thiel, Geoffrey S., additional, Vasiliadis, Haris S., additional, Vigorita, Vincent J., additional, Vince, Kelly G., additional, Violante, Bruno, additional, Voos, James E., additional, Vyas, Shail, additional, Walz, Daniel M., additional, Warwick, David, additional, Webber, Nicholas P., additional, Weiss, Jennifer, additional, Weiss, Kurt R., additional, Weissman, Barbara N., additional, Whiteside, Leo A., additional, Wickiewicz, Thomas L., additional, Williams, Bryan S., additional, Williams, Riley J., additional, Yen, Yi-Meng, additional, Zhang, Hong, additional, Zingde, Sumesh M., additional, and Zoga, Adam C., additional

Published
2012
Full Text
View/download PDF

106. Contributors

Author

Albright, Jay C., primary, Badarudeen, Sameer, additional, Bernstein, Robert M., additional, Bernstein, Saul M., additional, Brighton, Brian K., additional, Busch, Michael, additional, Campbell, Robert M., additional, Chambers, Henry G., additional, Demetracopoulos, Constantine A., additional, Diab, Mohammad, additional, Diltz, Matthew, additional, Finlayson, Craig J., additional, Flynn, John M., additional, Frank, Jeremy S., additional, Ganley, Theodore J., additional, Gholve, Purushottam Arjun, additional, Glotzbecker, Michael, additional, Goldfarb, Charles A., additional, Gordon, J. Eric, additional, Hedequist, Daniel J., additional, Hennrikus, William, additional, Herzenberg, John E., additional, Hutchinson, Douglas T., additional, James, Michelle A., additional, Karlin, Lawrence I., additional, Keeler, Kathryn A., additional, Kim, Young-Jo, additional, Kocher, Mininder S., additional, Kramer, Dennis E., additional, Krcik, James A., additional, Kuzyk, Paul R.T., additional, Laine, Jennifer C., additional, Langer, Jakub S., additional, LaReau, Justin M., additional, Luhmann, Scott J., additional, Mahan, Susan T., additional, Maskill, Lisa D., additional, Matheney, Travis, additional, Micheli, Lyle J., additional, Millis, Michael B., additional, Mubarak, Scott J., additional, Nasreddine, Adam, additional, Newton, Peter O., additional, Patterson, J. Megan M., additional, Price, Charles T., additional, Pring, Maya E., additional, Rebello, Gleeson, additional, Sankar, Wudbhav N., additional, Scher, David M., additional, Shore, Benjamin J., additional, Sink, Ernest L., additional, Siow, Hua Ming, additional, Smith, Brian G., additional, Snyder, Brian, additional, Spencer, Samantha A., additional, Sponseller, Paul D., additional, Spurdle, Craig J., additional, Standard, Shawn C., additional, Stanitski, Deborah F., additional, Stevens, Peter M., additional, Tan, Eric W., additional, Tis, John E., additional, Udall, John Hunt, additional, Wedge, John H., additional, Weinstein, Stuart L., additional, Yen, Yi-Meng, additional, and Zaltz, Ira, additional

Published
2011
Full Text
View/download PDF

108. Using a modified stroop task to implicitly discern the cognitive organization of alcohol expectancies

Author

Kramer, Dennis A. and Goldman, Mark S.

Subjects
Drinking of alcoholic beverages -- Psychological aspects, Expectation (Philosophy) -- Research, Expectation (Psychology), Psychology and mental health
Abstract

Alcohol expectancies have been statistically modeled as memory networks that influence future consumption. To test the organization of expectancies suggested by these models, a modified Stroop color-naming task incorporated expectancy words associated in past research with heavy and light drinking. Light and heavy drinkers ink-named expectancy targets after being cued with an alcohol beverage word or a nonalcohol beverage word. Consistent with predictions derived from statistical models, heavy drinkers displayed significant interference when arousing expectancy words had been primed by an alcohol beverage word, whereas light drinkers displayed significant interference when sedating expectancy targets had been so primed. These results reinforce the idea that mediation of alcohol use by expectancies may be implicit as well as explicit.

Published
2003

112. Association Between Psychological Readiness, Patient Reported Outcomes and Return to Sports Following Primary Anterior Cruciate Ligament Reconstruction: Readiness Outcomes Affecting Return-to-Sport (ROAR)

Author

Traver, Jessica, primary, Christino, Melissa, additional, Coene, Ryan, additional, Williams, Kathryn, additional, Sugimoto, Dai, additional, Kramer, Dennis, additional, Yen, Yi-Meng, additional, Kocher, Mininder, additional, Micheli, Lyle, additional, and Milewski, Matthew, additional

Published
2020
Full Text
View/download PDF

113. Females Have Earlier Muscle Strength and Functional Recovery After Bridge-Enhanced Anterior Cruciate Ligament Repair

Author

Barnett, Samuel, primary, Badger, Gary J., additional, Kiapour, Ata, additional, Yen, Yi-Meng, additional, Henderson, Rachael, additional, Freiberger, Christina, additional, Proffen, Benedikt, additional, Sant, Nicholas, additional, Trainor, Bethany, additional, Fleming, Braden C., additional, Micheli, Lyle J., additional, Murray, Martha M., additional, and Kramer, Dennis E., additional

Published
2020
Full Text
View/download PDF

115. Resolution of Pain and Predictors of Postoperative Opioid use after Bridge-Enhanced Anterior Cruciate Ligament Repair and Anterior Cruciate Ligament Reconstruction

Author

Barnett, Samuel, primary, Murray, Martha M., additional, Liu, Shanshan, additional, Micheli, Lyle J., additional, Henderson, Rachael, additional, Freiberger, Christina, additional, Trainor, Bethany, additional, Proffen, Benedikt, additional, Kramer, Dennis, additional, and Yen, Yi-Meng, additional

Published
2020
Full Text
View/download PDF

123. Regional Differences in Anterior Cruciate Ligament Signal Intensity After Surgical Treatment.

Author

Kiapour, Ata M., Flannery, Sean W., Murray, Martha M., Miller, Patricia E., Proffen, Benedikt L., Sant, Nicholas, Portilla, Gabriela, Sanborn, Ryan, Freiberger, Christina, Henderson, Rachael, Barnett, Samuel, Ecklund, Kirsten, Yen, Yi-Meng, Kramer, Dennis E., Micheli, Lyle J., and Fleming, Braden C.

Subjects
WOUND healing, ANTERIOR cruciate ligament, PHYSICAL therapy, MAGNETIC resonance imaging, POSTOPERATIVE care, AUTOGRAFTS, SURGICAL site, DESCRIPTIVE statistics, ANTERIOR cruciate ligament surgery, TIBIA, FEMUR, DATA analysis software, TRANSPLANTATION of organs, tissues, etc., LONGITUDINAL method
Abstract

Background: Magnetic resonance–based measurements of signal intensity have been used to track healing of surgically treated anterior cruciate ligaments (ACLs). However, it is unknown how the signal intensity values in different regions of the ligament or graft change during healing. Hypotheses: (1) Normalized signal intensity of the healing graft or repaired ACL is heterogeneous; (2) temporal changes in normalized signal intensity values differ among the tibial, middle, and femoral regions; and (3) there are no differences in regional normalized signal intensity values 2 years postoperatively among grafts, repaired ACLs, and contralateral native ACLs. Study Design: Cohort study; Level of evidence, 2. Methods: Magnetic resonance imaging scans were analyzed from patients in a trial comparing ACL reconstruction (n = 35) with bridge-enhanced ACL repair (n = 65). The ACLs were segmented from images acquired at 6, 12, and 24 months postoperatively and were partitioned into 3 sections along the longitudinal axis (femoral, middle, and tibial). Linear mixed modeling was used to compare location-specific differences in normalized ligament signal intensity among time points (6, 12, and 24 months) and groups (ACL reconstruction, repair, and contralateral native ACL). Results: For grafts, the middle region had a higher mean normalized signal intensity when compared with the femoral region at all time points (P <.01) but compared with the tibial region only at 6 months (P <.01). For repaired ACLs, the middle region had a higher mean normalized signal intensity versus the femoral region at all time points (P <.01) but versus the tibial region only at 6 and 12 months (P <.04). From 6 to 24 months, the grafts showed the greatest reduction in normalized signal intensity in the femoral and middle regions (vs tibial regions; P <.01), while there were no regional differences in repaired ACLs. At 2 years after surgery, repaired ACLs had a lower normalized signal intensity in the tibial region as compared with reconstructed grafts and contralateral native ACLs (P <.01). Conclusion: The results suggest that graft remodeling is location specific. Repaired ACLs were more homogeneous, with lower or comparable normalized signal intensity values at 2 years as compared with the contralateral native ACL and reconstructed grafts. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

125. DS_10.1177_0363546519836087 – Supplemental material for Predictors of Healing Ligament Size and Magnetic Resonance Signal Intensity at 6 Months After Bridge-Enhanced Anterior Cruciate Ligament Repair

Author

Murray, Martha M., Kiapour, Ata M., Kalish, Leslie A., Ecklund, Kirsten, Fleming, Braden C., Freiberger, Christina, Henderson, Rachael, Kramer, Dennis, Micheli, Lyle, and Yen, Yi-Meng

Subjects
FOS: Clinical medicine, 110323 Surgery, 110604 Sports Medicine, FOS: Health sciences, human activities, 110314 Orthopaedics
Abstract

Supplemental material, DS_10.1177_0363546519836087 for Predictors of Healing Ligament Size and Magnetic Resonance Signal Intensity at 6 Months After Bridge-Enhanced Anterior Cruciate Ligament Repair by Martha M. Murray, Ata M. Kiapour, Leslie A. Kalish, Kirsten Ecklund and Braden C. Fleming in The American Journal of Sports Medicine

Published
2019
Full Text
View/download PDF

126. DS_10.1177_0363546519850572 – Supplemental material for Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery

Author

Kiapour, Ata M., Ecklund, Kirsten, Murray, Martha M., Flutie, Brett, Freiberger, Christina, Henderson, Rachael, Kramer, Dennis, Micheli, Lyle, Thurber, Laura, Yen, Yi-Meng, and Fleming, Braden C.

Subjects
FOS: Clinical medicine, 110323 Surgery, 110604 Sports Medicine, FOS: Health sciences, 110314 Orthopaedics
Abstract

Supplemental material, DS_10.1177_0363546519850572 for Changes in Cross-sectional Area and Signal Intensity of Healing Anterior Cruciate Ligaments and Grafts in the First 2 Years After Surgery by Ata M. Kiapour, Kirsten Ecklund, Martha M. Murray, Brett Flutie, Christina Freiberger, Rachael Henderson, Dennis Kramer, Lyle Micheli, Laura Thurber, Yi-Meng Yen and Braden C. Fleming in The American Journal of Sports Medicine

Published
2019
Full Text
View/download PDF

127. The Effectiveness of a Functional Knee Brace on Joint-Position Sense in Anterior Cruciate Ligament-Reconstructed Individuals.

Author

Sugimoto, Dai, LeBlanc, Jessica C., Wooley, Sarah E., Micheli, Lyle J., and Kramer, Dennis E.

Subjects
KNEE physiology, RESEARCH methodology evaluation, ANTERIOR cruciate ligament surgery, EXPERIMENTAL design, ORTHOPEDIC apparatus, MEDLINE, ONLINE information services, PROPRIOCEPTION, SYSTEMATIC reviews, EVIDENCE-based medicine, PROFESSIONAL practice, DESCRIPTIVE statistics, EVALUATION
Abstract

It is estimated that approximately 350,000 individuals undergo anterior cruciate ligament (ACL) reconstruction surgery in each year in the US. Although ACL-reconstruction surgery and postoperative rehabilitation are successfully completed, deficits in postural control remain prevalent in ACL-reconstructed individuals. In order to assist the lack of balance ability and reduce the risk of retear of the reconstructed ACL, physicians often provide a functional knee brace on the patients' return to physical activity. However, it is not known whether use of the functional knee brace enhances knee-joint position sense in individuals with ACL reconstruction. Thus, the effect of a functional knee brace on knee-joint position sense in an ACL-reconstructed population needs be critically appraised. After systematically review of previously published literature, 3 studies that investigated the effect of a functional knee brace in ACL-reconstructed individuals using joint-position-sense measures were found. They were rated as level 2b evidence in the Centre of Evidence Based Medicine Level of Evidence chart. Synthesis of the reviewed studies indicated inconsistent evidence of a functional knee brace on joint-position improvement after ACL reconstruction. More research is needed to provide sufficient evidence on the effect of a functional knee brace on joint-position sense after ACL reconstruction. Future studies need to measure joint-position sense in closed-kinetic-chain fashion since ACL injury usually occurs under weight-bearing conditions. [ABSTRACT FROM AUTHOR]

Published
2016
Full Text
View/download PDF

136. Outcomes Following ACL Reconstruction Using Patellar Tendon Versus Hamstring Tendon Autograft In Adolescent Athletes: An Age, Sex, And Bmi-matched Comparative Cohort Study

Author

Heyworth, Benton E., primary, Liotta, Elizabeth S., additional, Fabricant, Peter D., additional, Bassett, Ashley J., additional, Waites, Cameron, additional, Miller, Patricia, additional, Kramer, Dennis E., additional, Kocher, Mininder S., additional, and Micheli, Lyle J., additional

Published
2019
Full Text
View/download PDF

139. OUTCOMES FOLLOWING ACL RECONSTRUCTION USING PATELLAR TENDON VERSUS HAMSTRING TENDON AUTOGRAFT IN ADOLESCENT ATHLETES: AN AGE-MATCH, SEX-MATCHED, AND BODY MASS INDEX-MATCHED COHORT STUDY

Author

Heyworth, Benton E., primary, Liotta, Elizabeth S., additional, Fabricant, Peter D., additional, Tisosky, Ashley J., additional, Waites, Cameron, additional, Miller, Patricia E., additional, Kramer, Dennis E., additional, Kocher, Mininder S., additional, and Micheli, Lyle J., additional

Published
2019
Full Text
View/download PDF

140. Bridge-Enhanced ACL Repair: Two Year Results of the First In Human Study

Author

Murray, Martha M., primary, Kalish, Leslie, additional, Fleming, Braden C., additional, Flutie, Brett, additional, Thurber, Laura, additional, Freiberger, Christina, additional, Henderson, Rachael, additional, Perrone, Gabriel, additional, Proffen, Benedikt, additional, Kramer, Dennis E., additional, Yen, Yi-Meng, additional, and Micheli, Lyle J., additional

Published
2019
Full Text
View/download PDF

144. High School Students With Emotional and Behavioral Disorders Perceptions of School Climate

Author

Gage, Nicholas A., Kramer, Dennis A., and Ellis, Kaci

Abstract

Students with emotional and behavioral disorders (EBDs), particularly those in high school, present myriad challenges for educators. Although research suggests that students with EBDs experience schooling differently than their peers, few studies have examined differences in perceptions of school climate. School climate is a multidimensional construct consisting of students’ perceptions of physical and social school environments. To address this gap, we leveraged school climate data from more than 350,000 high school students, including more than 5,000 with or at risk for EBDs, in Georgia. We estimated a series of multilevel models and found that students with or at risk for EBDs consistently report more negative perceptions of school climate than their peers across all school climate domains. We also examined whether individualized education program (IEP) services affected perceptions for students with EBDs, finding more positive perceptions for some domains for students with IEP services for EBDs compared with students with EBDs, but no IEP services. Implications and limitations are then discussed.

Published
2021
Full Text
View/download PDF

145. Bridge-Enhanced Anterior Cruciate Ligament Repair Is Not Inferior to Autograft Anterior Cruciate Ligament Reconstruction at 2 Years: Results of a Prospective Randomized Clinical Trial.

Author

Murray, Martha M., Fleming, Braden C., Badger, Gary J., Freiberger, Christina, Henderson, Rachael, Barnett, Samuel, Kiapour, Ata, Ecklund, Kirsten, Proffen, Benedikt, Sant, Nicholas, Kramer, Dennis E., Micheli, Lyle J., and Yen, Yi-Meng

Subjects
ANTERIOR cruciate ligament surgery, ANTERIOR cruciate ligament injuries, AUTOGRAFTS, COMPARATIVE studies, CONFIDENCE intervals, FISHER exact test, JOINT hypermobility, KNEE, LIFE skills, MUSCLE strength, RESEARCH funding, STATISTICAL sampling, SUTURES, T-test (Statistics), HAMSTRING muscle, RANDOMIZED controlled trials, TREATMENT effectiveness, DESCRIPTIVE statistics, MANN Whitney U Test
Abstract

Background: Preclinical studies suggest that for complete midsubstance anterior cruciate ligament (ACL) injuries, a suture repair of the ACL augmented with a protein implant placed in the gap between the torn ends (bridge-enhanced ACL repair [BEAR]) may be a viable alternative to ACL reconstruction (ACLR). Hypothesis: We hypothesized that patients treated with BEAR would have a noninferior patient-reported outcomes (International Knee Documentation Committee [IKDC] Subjective Score; prespecified noninferiority margin, –11.5 points) and instrumented anteroposterior (AP) knee laxity (prespecified noninferiority margin, +2-mm side-to-side difference) and superior muscle strength at 2 years after surgery when compared with patients who underwent ACLR with autograft. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: One hundred patients (median age, 17 years; median preoperative Marx activity score, 16) with complete midsubstance ACL injuries were enrolled and underwent surgery within 45 days of injury. Patients were randomly assigned to receive either BEAR (n = 65) or autograft ACLR (n = 35 [33 with quadrupled semitendinosus-gracilis and 2 with bone–patellar tendon–bone]). Outcomes—including the IKDC Subjective Score, the side-to-side difference in instrumented AP knee laxity, and muscle strength—were assessed at 2 years by an independent examiner blinded to the procedure. Patients were unblinded after their 2-year visit. Results: In total, 96% of the patients returned for 2-year follow-up. Noninferiority criteria were met for both the IKDC Subjective Score (BEAR, 88.9 points; ACLR, 84.8 points; mean difference, 4.1 points [95% CI, –1.5 to 9.7]) and the side-to-side difference in AP knee laxity (BEAR, 1.61 mm; ACLR, 1.77 mm; mean difference, –0.15 mm [95% CI, –1.48 to 1.17]). The BEAR group had a significantly higher mean hamstring muscle strength index than the ACLR group at 2 years (98.2% vs 63.2%; P <.001). In addition, 14% of the BEAR group and 6% of the ACLR group had a reinjury that required a second ipsilateral ACL surgical procedure (P =.32). Furthermore, the 8 patients who converted from BEAR to ACLR in the study period and returned for the 2-year postoperative visit had similar primary outcomes to patients who had a single ipsilateral ACL procedure. Conclusion: BEAR resulted in noninferior patient-reported outcomes and AP knee laxity and superior hamstring muscle strength when compared with autograft ACLR at 2-year follow-up in a young and active cohort. These promising results suggest that longer-term studies of this technique are justified. Registration: NCT02664545 (ClinicalTrials.gov identifier) [ABSTRACT FROM AUTHOR]

Published
2020
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results