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Introduction: Recently, a new minimally invasive single bundle technique for anatomic ACL reconstruction has been described, called the 'All-Inside graft-link technique'. One of the advantages of this procedure is the reduced morbidity at the donor site as the graft choice is the quadrupled semitendinosus, thus sparing the gracilis tendon. The aim of this study was to evaluate isokinetic flexion strength recovery in patients who underwent a gracilis sparing technique compared to those with a full-tibial tunnel technique using a doubled gracilis and semitendinosus tendons (DGST) graft. Methods: Patients were divided into two groups: Group A (22 patients) who underwent ACL reconstruction performed with an All-Inside graft-link technique; Group B (22 patients) who underwent ACL reconstruction with an Out-In technique and DGST graft. At a mean follow-up of 13 months, quadriceps and hamstring isokinetic peak torque deficits were recorded. Results: In group A, the mean side to side peak torque flexion difference between the operated and non-operated limbs was −3% and the mean torque at 30° was −7.5% at high angular velocity (180°/sec); the mean peak flexion torque was 7.2% and the mean torque at 30° was 3.1% at low angular velocity (60°/sec). In group B, the mean side to side peak flexion torque was −3.5% and the mean torque at 30° was −7.6% at high angular velocity (180°/sec); the mean peak flexion torque was −7.2% and the mean torque at 30° was −11% at low angular velocity (60°/sec). A statistically significant difference was found between the two groups at lower angular velocity both for the mean peak flexion torque and the mean torque at 30° (p = 0.009), with better results in the study group. Discussion/conclusion: Gracilis sparing technique is a minimally invasive technique for ACL reconstruction and yielded a significantly better flexion strength recovery at lower angular velocity compared to a full tibial tunnel technique with DGST for ACL reconstruction. [ABSTRACT FROM AUTHOR]

The Anatomy of the lateral aspect of the knee has been increasingly debated in recent literature, the morphology and function of anterolateral ligament (ALL) are not clearly understood even today (1, 2). The aim of present study was to provide for the first time a detailed ultrastructural characterization of the ALL and its ultrastructure collagen arrangement using the light microscopy (LM), the transmission electron microscopy (TEM) and variable pressure scanning electron microscopy (VP-SEM). Eight paired samples from four fresh-frozen males cadavers were used for the study. Samples were harvested from the ALL, from the anterolateral capsule and from the medial collateral ligament (MCL). All samples were treated for microscopy techniques. Histological analysis showed similar morphology features between ALL and MCL sectioning, but clear differences are evident in comparison to the knee capsule. At TEM the collagen fibers of ALL and MCL showed similarity in the ultrastructural morphology, both collagen fibers have parallel alignment mainly orientated longitudinally. Significant structural difference of the tissue of the fibrous capsule compared to the ligaments may be observed. The VP-SEM highlighted that ALL and MCL morphology has shown aligned arrangements of fiber bundles densely packed, completely different assembling organization of the fibers were observed in fibrous capsule. Data from this study demonstrate that the ALL and MCL have comparable ultrastructural properties. It can further lead us to speculate that the ALL is a ligamentous structure distinct from the knee capsule. [ABSTRACT FROM AUTHOR]

Background: Normative data for passive range of motion are well established, but daily living is comprised of active motion. The purpose of this study was to establish normative values for active range of motion of the shoulder across age, sex, and arm. Our hypotheses were that active range of motion of the shoulder (1) decreases with age group, (2) differs between males and females, and (3) differs between the right arm and left arm., Methods: Shoulder active range of motion was captured with an eight-camera markerless motion capture system. Data were collected for a heterogenous sample of 6635 males and females of all ages. For each subject, 6 shoulder motions were collected with maximum values measured: external rotation, internal rotation, flexion, extension, abduction, and horizontal abduction. Three-way repeated measures analyses were performed, with 2 between-subject factors (age group and sex) and 1 within-subject factor (arm). The unadjusted threshold for statistical significance was α = 0.05., Results: External rotation decreased with age (approximately 10° decrease from below 30 years to above 60 years). External rotation was approximately 5° greater in the right arm, whereas internal rotation was approximately 5° greater in the left arm. Flexion decreased with age (approximately 15° decrease from below 20 years to above 60 years). For age groups from 10 to 59 years, extension and horizontal abduction were approximately 5° to 10° greater in females than males. Abduction was greater for females than males. Abduction was also greater in younger people (aged 10-29 years) than older people., Conclusion: In general, active range of motion of the shoulder decreases with age. Sex (male/female) and arm side (right/left) also influence shoulder range of motion., (© 2022 The Authors.)