2024
Medial-Sided Repair in Multi-Ligamentous Knee Injury
Patel R, Green J, Moran J, Santos E, Medvecky M. Medial-Sided Repair in Multi-Ligamentous Knee Injury. Video Journal Of Sports Medicine 2024, 4: 26350254241226723. DOI: 10.1177/26350254241226723.Peer-Reviewed Original ResearchMulti-ligamentous knee injuriesSuperficial medial collateral ligamentPosterior oblique ligamentValgus stabilityKnee injuriesDeep medial collateral ligamentMedial collateral ligamentPatient-reported outcomesMedial structuresMedial knee structuresIntra-articular entrapmentKnee loadingCollateral ligamentElite athletesExternal rotationValgus laxityKnee functionTibial plateau fracturesMedial patellofemoral ligament tearThird-degree injuryOrthopedic injuriesKnee stabilityKneeAnatomic alignmentKnee structuresThe Active External Rotation Sign: A Physical Exam Technique for Detecting Posterolateral Corner Injury in Chronic Multiligament Knee Injuries
Levitt S, Zazulak B, Green J, Medvecky M. The Active External Rotation Sign: A Physical Exam Technique for Detecting Posterolateral Corner Injury in Chronic Multiligament Knee Injuries. Video Journal Of Sports Medicine 2024, 4 DOI: 10.1177/26350254241241082.Peer-Reviewed Original ResearchKnee injuriesExternal rotationDial testPosterolateral corner injuriesPLC injuriesPhysical exam testsPosterolateral cornerVarus stress testKnee flexionChronic PLC injuriesDynamic external rotationPosterior tibial translationBiceps femoris tendonBiceps femorisChronic multiligament knee injuriesNon-operative treatmentKnee motionMultiligament knee injuriesHigh index of suspicionPassive motionPosterior translationInjury identificationTibial translationIndex of suspicionKneeClinical and Functional Outcomes of Documented Knee Dislocation Versus Multiligamentous Knee Injury: A Comparison of KD3 Injuries at Mean 6.5 Years Follow-up
Hughes A, Li Z, Garra S, Green J, Chalem I, Triana J, Jazrawi L, Medvecky M, Alaia M. Clinical and Functional Outcomes of Documented Knee Dislocation Versus Multiligamentous Knee Injury: A Comparison of KD3 Injuries at Mean 6.5 Years Follow-up. The American Journal Of Sports Medicine 2024, 52: 961-967. PMID: 38400667, DOI: 10.1177/03635465241231032.Peer-Reviewed Original ResearchIncidence of neurovascular injuryMultiligamentous knee injuriesVisual analog scaleTegner activity levelFollow-upKnee injuriesNeurovascular injuryCohort studyActivity levelsDocumented dislocationSubgroup analysisInternational Knee Documentation Committee (IKDC) scoreKnee dislocationVisual analog scale painFunctional outcomesMulticenter retrospective cohort studyLong-term follow-upTegner activity scaleMultivariate linear regressionLevel of evidencePoor clinical outcomesRetrospective cohort studyPredictive of outcomeActivity ScaleInjury patterns
2023
Patient-reported outcomes and return to pre-injury activities after surgical treatment of multi-ligamentous knee injuries in patients over 40-years-old: Average 5-years follow-up
Li Z, Green J, Chalem I, Triana J, Rao N, Hughes A, Campbell K, Jazrawi L, Medvecky M, Alaia M. Patient-reported outcomes and return to pre-injury activities after surgical treatment of multi-ligamentous knee injuries in patients over 40-years-old: Average 5-years follow-up. The Knee 2023, 46: 89-98. PMID: 38070381, DOI: 10.1016/j.knee.2023.11.014.Peer-Reviewed Original ResearchMulti-ligamentous knee injuriesPre-injury activitiesSurgical treatmentLysholm scoreOlder patientsCase seriesClinical outcomesKnee injuriesInternational Knee Documentation Committee scoreMulti-center retrospective case seriesFair clinical outcomePre-injury sportTegner activity scaleRetrospective case seriesTime of injuryPatient-reported outcomesMean IKDCPreoperative characteristicsKnee dislocationDevastating injuriesPatientsActivity ScaleIKDCInjuryStepwise linear regressionPoster 306: Examining Preoperative Magnetic Resonance Imaging for Medial Meniscal Ramp Lesions in Patients Surgically Treated for Acute Grade III Combined Posterolateral Corner Knee Injuries
Jimenez A, Katz L, Wang A, McLaughlin W, Gillinov S, Kunze K, Hewett T, Alaia M, LaPrade R, Medvecky M, Moran J. Poster 306: Examining Preoperative Magnetic Resonance Imaging for Medial Meniscal Ramp Lesions in Patients Surgically Treated for Acute Grade III Combined Posterolateral Corner Knee Injuries. Orthopaedic Journal Of Sports Medicine 2023, 11: 2325967123s00279. PMCID: PMC10392321, DOI: 10.1177/2325967123s00279.Peer-Reviewed Original ResearchPreoperative magnetic resonance imagingMedial meniscal ramp lesionsMulti-ligament knee injuriesAcute grade IIIMeniscal ramp lesionsMagnetic resonance imagingPosterolateral corner knee injuriesRamp lesionsIntra-class correlation coefficientPLC injuriesGrade IIIKnee injuriesBone bruisingBone bruiseResonance imagingAnterior cruciate ligament injuryMulti-ligament reconstructionCruciate ligament injuryDays of injuryMeniscocapsular tearsConsecutive patientsLigament injuryMeniscal injurySame patientLevel IPoster 308: Clinical Outcomes After Multi-ligamentous Knee Injuries in Patients Over 40-Years-Old at Average 4-Years Follow-Up
Green J, Chalem I, Triana J, Rao N, Moran J, buldo-licciardi M, Jazrawi L, Campbell K, Medvecky M, Alaia M, Li Z. Poster 308: Clinical Outcomes After Multi-ligamentous Knee Injuries in Patients Over 40-Years-Old at Average 4-Years Follow-Up. Orthopaedic Journal Of Sports Medicine 2023, 11: 2325967123s00281. PMCID: PMC10392478, DOI: 10.1177/2325967123s00281.Peer-Reviewed Original ResearchMulti-ligamentous knee injuriesTegner activity scaleVisual analog scaleClinical outcomesOperative managementLysholm scoreKnee injuriesOutcome measuresMulti-center retrospective cohort studyRetrospective cohort studyLysholm knee scoreSubjective Knee FormMechanism of injuryLong-term outcomesPatient-reported outcomesPoor outcome measuresHigh-energy mechanismsRegression modelsDaily functional statusHistory of dislocationTegner scoreCohort studyKnee scoreSurgical repairSurgical treatmentEstablishing a Consensus Definition of a Knee Fracture-Dislocation (Schenck Knee Dislocation V) Using a Global Modified Delphi Method
Medvecky M, Kahan J, Richter D, McLaughlin W, Moran J, Islam W, Miller M, Wascher D, Treme G, Campos T, Held M, Schenck R. Establishing a Consensus Definition of a Knee Fracture-Dislocation (Schenck Knee Dislocation V) Using a Global Modified Delphi Method. Journal Of Bone And Joint Surgery 2023, 105: 1182-1192. PMID: 37352339, DOI: 10.2106/jbjs.23.00039.Peer-Reviewed Original ResearchConceptsCompression fracturesArticular fracturesResponse rateFracture patternsInferior pole fractureTibial tubercle fracturesMultiligamentous knee injuriesKnee ligament injuriesTibial plateau fracturesWeight-bearing surfaceSpecific fracture patternsTubercle fracturesAvulsion fractureFracture dislocationKnee injuriesLigament injuryBody fracturesComplex injuriesPlateau fracturesSurface involvementType IIIbType IIIAConsensus definitionClinical scenariosDelphi techniqueExamining the Schenck KD I Classification in Patients With Documented Tibiofemoral Knee Dislocations: A Multicenter Retrospective Case Series
Green J, Yalcin S, Moran J, Vasavada K, Kahan J, Li Z, Alaia M, Medvecky M. Examining the Schenck KD I Classification in Patients With Documented Tibiofemoral Knee Dislocations: A Multicenter Retrospective Case Series. Orthopaedic Journal Of Sports Medicine 2023, 11: 23259671231168892. PMID: 37378278, PMCID: PMC10291419, DOI: 10.1177/23259671231168892.Peer-Reviewed Original ResearchMultiligament knee injuriesTibiofemoral knee dislocationTibiofemoral dislocationKnee dislocationCase seriesSports medicine fellowship-trained surgeonsMulticenter retrospective case seriesMagnetic resonance imaging (MRI) scansRetrospective case seriesRetrospective chart reviewResonance imaging scansFellowship-trained surgeonsFuture outcome studiesLevel of evidenceBicruciate injuriesChart reviewI injuryRadiological evidenceSurgical managementKnee injuriesExtensor mechanismCruciate ligamentImaging scansKnee radiographsCollateral injuryExtensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees
Medvecky M, Kahan J, Richter D, Islam W, McLaughlin W, Moran J, Alaia M, Miller M, Wascher D, Treme G, Campos T, Held M, Schenck R, Group T. Extensor Mechanism Disruption Impacts Treatment of Dislocated and Multiligament Injured Knees. Journal Of Bone And Joint Surgery 2023, 105: 1012-1019. PMID: 37186688, DOI: 10.2106/jbjs.23.00079.Peer-Reviewed Original ResearchConceptsMultiligament knee injuriesTreatment algorithmResponse rateExtensor mechanism disruptionLittle clinical evidenceLarge case seriesTreatment of patientsClinical outcome dataNumerous clinical factorsPositive consensusClassic Delphi techniqueInitial surgeryMechanism disruptionClinical factorsInjured kneesRare injuryCase seriesKnee injuriesProspective studyClinical evidenceOptimal treatmentLigamentous reconstructionTreatment decisionsOutcome dataClinical scenariosExamining Preoperative MRI for Medial Meniscal Ramp Lesions in Patients Surgically Treated for Acute Grade 3 Combined Posterolateral Corner Knee Injury
Moran J, Jimenez A, Katz L, Wang A, McLaughlin W, Gillinov S, Patel R, Kunze K, Hewett T, Alaia M, LaPrade R, Medvecky M. Examining Preoperative MRI for Medial Meniscal Ramp Lesions in Patients Surgically Treated for Acute Grade 3 Combined Posterolateral Corner Knee Injury. Orthopaedic Journal Of Sports Medicine 2023, 11: 23259671221144767. PMID: 36756171, PMCID: PMC9900669, DOI: 10.1177/23259671221144767.Peer-Reviewed Original ResearchPreoperative magnetic resonance imagingMedial meniscal ramp lesionsAcute grade 3Meniscal ramp lesionsMultiligament knee injuriesMagnetic resonance imagingPosterolateral corner knee injuriesRamp lesionsPLC injuriesIntraclass correlation coefficientGrade 3Knee injuriesBone bruisingBone bruiseAnterior cruciate ligament injuryLevel 1 trauma centerCruciate ligament injuryDays of injuryCross-sectional studyLevel of evidenceMeniscocapsular tearsConsecutive patientsLigament injuryTrauma centerMultiligament reconstructionComparative Success of Repair Versus Reconstruction for Knee Extra-articular Ligament Injuries
Kahan J, Burroughs P, Mclaughlin W, Schneble C, Moran J, Joo P, Modrak M, Richter D, Wascher D, Treme G, Schenck R, Grauer J, Medvecky M. Comparative Success of Repair Versus Reconstruction for Knee Extra-articular Ligament Injuries. Orthopaedic Journal Of Sports Medicine 2023, 11: 23259671221143539. PMID: 36743731, PMCID: PMC9893380, DOI: 10.1177/23259671221143539.Peer-Reviewed Original ResearchCruciate ligament reconstructionLigament injurySurgical repairLigament reconstructionRevision surgeryKnee injuriesExtra-articular ligament reconstructionSubsequent surgery ratesOptimal surgical treatmentKnee ligament injuriesHigher revision rateLevel of evidenceLarge national databaseHigh rateLigament proceduresReconstruction cohortRepair cohortCohort studySurgical treatmentSurgery ratesPatient cohortSecondary proceduresRevision rateLigamentous reconstructionSurgical technique
2022
Spontaneous Healing of a Posteriorly Displaced Lateral Meniscus Bucket-Handle Tear in a Multiligament Knee Injury
Green J, Seddio A, Roybal D, Moran J, Katz L, Medvecky M. Spontaneous Healing of a Posteriorly Displaced Lateral Meniscus Bucket-Handle Tear in a Multiligament Knee Injury. JBJS Case Connector 2022, 12: e22.00503. PMID: 36821095, DOI: 10.2106/jbjs.cc.22.00503.Peer-Reviewed Original ResearchConceptsBucket-handle meniscus tearsMultiligament knee injuriesKnee injuriesSpontaneous healingAtypical magnetic resonanceAnterior cruciate ligamentBucket-handle tearPolytrauma patientsCompartment syndromeCruciate ligamentMeniscus tearsConcomitant ruptureUnusual caseMedial meniscusMeniscal repairFragment reductionLateral meniscusInjuryTearsHealingMagnetic resonancePainPatientsSyndromeExtravasationOver One-Third of Patients With Multiligament Knee Injuries and an Intact Anterior Cruciate Ligament Demonstrate Medial Meniscal Ramp Lesions on Magnetic Resonance Imaging
Moran J, Schneble C, Katz L, Jimenez A, McLaughlin W, Vasavada K, Wang A, Kunze K, Chahla J, LaPrade R, Alaia M, Medvecky M. Over One-Third of Patients With Multiligament Knee Injuries and an Intact Anterior Cruciate Ligament Demonstrate Medial Meniscal Ramp Lesions on Magnetic Resonance Imaging. Arthroscopy The Journal Of Arthroscopic And Related Surgery 2022, 39: 592-599. PMID: 36575108, DOI: 10.1016/j.arthro.2022.10.022.Peer-Reviewed Original ResearchConceptsMedial meniscus ramp lesionsIntact anterior cruciate ligamentMultiligament knee injuriesAnterior cruciate ligamentMagnetic resonance imagingRamp lesionsBone bruiseBone bruisingKnee injuriesCruciate ligamentMedial meniscal ramp lesionsResonance imagingPreoperative magnetic resonance imagingMeniscal ramp lesionsRetrospective case seriesPosterior cruciate ligamentOne-thirdIntraclass correlation coefficientConsecutive patientsRetrospective reviewCase seriesLigament reconstructionOperative reportsLevel IVLevel IRepair of Acute Grade 3 Combined Posterolateral Corner Avulsion Injuries Using an Enhanced Fixation Technique
Moran J, Kahan J, Schneble C, McLaughlin W, Green J, Gillinov S, Cheng R, Patel R, Jimenez A, LaPrade R, Schenck R, Medvecky M. Repair of Acute Grade 3 Combined Posterolateral Corner Avulsion Injuries Using an Enhanced Fixation Technique. Orthopaedic Journal Of Sports Medicine 2022, 10: 23259671221131817. PMID: 36389620, PMCID: PMC9663643, DOI: 10.1177/23259671221131817.Peer-Reviewed Original ResearchInternational Knee Documentation CommitteePatient-reported outcome measuresMultiligament knee injuriesPeroneal nerve injuryAvulsion injuriesNerve injuryKrackow sutureLysholm scoreAcute repairKnee injuriesOutcome scoresMean International Knee Documentation CommitteePosterolateral cornerSubjective International Knee Documentation CommitteeSubjective outcome scoresAcute grade 3Level of evidenceFailure rateLower outcome scoresCruciate injuryTegner scoreCase seriesSurgical repairGraft augmentationSalvage procedurePoorer functional Outcomes in Patients with Multi‐Ligamentous Knee Injury with Concomitant Patellar Tendon Ruptures at 5 years Follow‐Up
Mojica ES, Bi AS, Vasavada K, Moran J, Buzin S, Kahan J, Alaia EF, Jazrawi LM, Medvecky MJ, Alaia MJ. Poorer functional Outcomes in Patients with Multi‐Ligamentous Knee Injury with Concomitant Patellar Tendon Ruptures at 5 years Follow‐Up. Knee Surgery, Sports Traumatology, Arthroscopy 2022, 31: 325-331. PMID: 36048200, DOI: 10.1007/s00167-022-07110-3.Peer-Reviewed Original ResearchConceptsMulti-ligamentous knee injuriesPatellar tendon ruptureTendon ruptureBody mass indexKnee injuriesFunctional outcomeInternational Knee Documentation Committee Subjective Knee FormPoorer Functional OutcomesWorse functional outcomeExtensor mechanism injuriesSubjective Knee FormHigh-energy injuriesPatient-reported outcomesPatellar tendon injuryPropensity-score matchingSchenck classificationTegner scoreLysholm scoreMulticenter cohortClinical outcomesMechanism injuriesRare presentationSurgical repairKnee FormMass indexPredictors Using Machine Learning of Complete Peroneal Nerve Palsy Recovery After Multiligamentous Knee Injury: A Multicenter Retrospective Cohort Study
Vasavada K, Shankar DS, Bi AS, Moran J, Petrera M, Kahan J, Alaia EF, Medvecky MJ, Alaia MJ. Predictors Using Machine Learning of Complete Peroneal Nerve Palsy Recovery After Multiligamentous Knee Injury: A Multicenter Retrospective Cohort Study. Orthopaedic Journal Of Sports Medicine 2022, 10: 23259671221121410. PMID: 36172267, PMCID: PMC9511346, DOI: 10.1177/23259671221121410.Peer-Reviewed Original ResearchMultiligamentous knee injuriesBody mass indexPN palsyKnee injuriesMale sexMulticenter retrospective cohort studyElevated body mass indexPeroneal nerve palsyRetrospective cohort studyUrban hospital systemCase-control studyLevel of evidenceMagnetic resonance imagingLarge patient data setsNonrecovery groupNerve palsyNerve recoveryPostoperative variablesCohort studyKnee dislocationRetrospective reviewFoot dropMass indexNerve contusionPhysical examinationRelationship Between Peroneal Nerve and Anterior Cruciate Ligament Involvement in Multiligamentous Knee Injury: A Multicenter Study
Markus DH, Mojica ES, Bi A, Kahan JB, Moran J, Mannino BJ, Alaia EF, Jazrawi LM, Medvecky MJ, Alaia MJ. Relationship Between Peroneal Nerve and Anterior Cruciate Ligament Involvement in Multiligamentous Knee Injury: A Multicenter Study. Journal Of The American Academy Of Orthopaedic Surgeons 2022, 30: e1461-e1466. PMID: 36326829, DOI: 10.5435/jaaos-d-21-01252.Peer-Reviewed Original ResearchConceptsMultiligamentous knee injuriesPeroneal nerve injuryACL tear groupNerve injuryPosterolateral corner injuriesNerve palsyChart reviewKnee injuriesTear groupMulticenter retrospective cohort analysisComplete anterior cruciate ligament ruptureAnterior cruciate ligament ruptureMore knee ligamentsParticular injury patternPeroneal nerve palsyRetrospective chart reviewRetrospective cohort analysisBody mass indexCruciate ligament ruptureGreater relative riskComplete injurySurgical characteristicsIntact ACLLigament involvementPeroneal nervePosterior Cruciate Ligament
Schneble C, Fanelli G, Medvecky M. Posterior Cruciate Ligament. 2022, 87-99. DOI: 10.1007/978-3-030-94789-7_6.Peer-Reviewed Original ResearchPosterior cruciate ligamentMultiligamentous knee injuriesPCL injuriesCollateral ligament repairKnee injuriesCruciate ligamentLigament repairMultiple treatment optionsZone of injuryPosterior tibial translationSoft tissue injuriesHybrid repairPCL reconstructionChronic injuryTibial translationTreatment optionsTissue injuryInjuryPrimary restraintAppropriate timingCruciateRepairLigamentNumerous factorsChronicityExamining the Bone Bruise Patterns in Multiligament Knee Injuries With Peroneal Nerve Injury
Moran J, Schneble CA, Katz LD, Fosam A, Wang A, Li DT, Kahan JB, McLaughlin WM, Jokl P, Hewett TE, LaPrade RF, Medvecky MJ. Examining the Bone Bruise Patterns in Multiligament Knee Injuries With Peroneal Nerve Injury. The American Journal Of Sports Medicine 2022, 50: 1618-1626. PMID: 35384729, DOI: 10.1177/03635465221087406.Peer-Reviewed Original ResearchConceptsMultiligament knee injuriesBone bruise patternsPeroneal nerve injuryMagnetic resonance imagingCPN injuryPhysical examinationBone bruisingNerve injuryBone bruisePLC injuriesKnee injuriesBruise patternsCommon peroneal nerve injuryLevel 1 trauma centerBoard-certified musculoskeletal radiologistsHigh-energy traumaPosterolateral corner injuriesLevel of evidenceCPN palsySchenck classificationInjury subtypesKnee dislocationCase seriesTrauma centerLigamentous injuries
2021
The Pathoanatomy of Posterolateral Corner Ligamentous Disruption in Multiligament Knee Injuries Is Predictive of Peroneal Nerve Injury: Response
Kahan J, Li D, Schneble C, Huang P, Porrino J, Medvecky M. The Pathoanatomy of Posterolateral Corner Ligamentous Disruption in Multiligament Knee Injuries Is Predictive of Peroneal Nerve Injury: Response. The American Journal Of Sports Medicine 2021, 49: np27-np28. PMID: 34081555, DOI: 10.1177/03635465211014491.Peer-Reviewed Original Research