Background: Female athletes have a higher risk of anterior cruciate ligament injury than their male counterparts who play at similar levels in sports involving pivoting and landing. Hypothesis: The competitive female basketball players who participated in a sports injury prevention training program would show better muscle strength and flexibility and improved biomechanical properties associated with anterior cruciate ligament injury than during the pretraining period and than posttraining parameters in a control group. Study Design: Controlled laboratory study. Methods: A total of 22 high school female basketball players were recruited and randomly divided into 2 groups (the experimental group and the control group, 11 participants each). The experimental group was instructed in the 6 parts of the sports injury prevention training program and performed it during the first 20 minutes of team practice for the next 8 weeks, while the control group performed their regular training program. Both groups were tested with a rebound-jump task before and after the 8-week period. A total of 21 reflective markers were placed in preassigned positions. In this controlled laboratory study, a 2-way analysis of variance (2 × 2) experimental design was used for the statistical analysis (P < .05) using the experimental group and a testing session as within and between factors, respectively. Post hoc tests with Sidak correction were used when significant factor effects and/or interactions were observed. Results: A comparison of the experimental group's pretraining and posttraining results identified training effects on all strength parameters (P = .004 to .043) and on knee flexion, which reflects increased flexibility (P = .022). The experimental group showed higher knee flexion angles (P = .024), greater interknee distances (P = .004), lower hamstring-quadriceps ratios (P = .023), and lower maximum knee extension torques (P = .043) after training. In the control group, no statistical differences were observed between pretraining and posttraining findings (P = .084 to .873). At pretraining, no significant differences were observed between the 2 groups for any parameter (P = .067 to .784). However, a comparison of the 2 groups after training revealed that the experimental group had significantly higher knee flexion angles (P = .023), greater knee distances (P = .005), lower hamstring-quadriceps ratios (P = .021), lower maximum knee extension torques (P = .124), and higher maximum knee abduction torques (P = .043) than the control group. Conclusion: The sports injury prevention training program improved the strength and flexibility of the competitive female basketball players tested and biomechanical properties associated with anterior cruciate ligament injury as compared with pretraining parameters and with posttraining parameters in the control group. Clinical Relevance: This injury prevention program could potentially modify the flexibility, strength, and biomechanical properties associated with ACL injury and lower the athlete's risk for injury.

Background: In the symptomatic discoid lateral meniscus, the effectiveness of preoperative magnetic resonance imaging (MRI) is not well documented. Hypothesis: Magnetic resonance imaging classification will provide more information to the surgeon in choosing the appropriate treatment methods with the help of arthroscopic findings. Study design: Cohort study (diagnosis); Level of evidence, 2. Methods: Sixty-seven patients (82 knees) were reviewed. The preoperative MRI was checked in 76 of 82 knees. The Lysholm and Ikeuchi grading scales were evaluated. Images were analyzed from MRI, and findings were classified into 4 categories: no shift, anterocentral shift, posterocentral shift, and central shift. Tear pattern classifications were based on arthroscopic findings: horizontal tear, peripheral tear, horizontal and peripheral tear, posterolateral corner loss, and others. The correlations between MRI classification tear patterns and surgical methods were analyzed using the chi-square test or the Fisher exact test. The sensitivity, specificity, and accuracy of shift in preoperative MRI–according to the existence of peripheral tear when corroborated with arthroscopy–were also analyzed with the chi-square test. Inter- and intraobserver reliability was statistically analyzed by producing the inter- and intraclass correlation coefficient. Results: The mean preoperative Lysholm score was 77.3 (range, 43-97), and the last follow-up Lysholm score had increased to 96.8 (range, 84-100; P <. 001). At last follow-up (100% follow-up), the Ikeuchi grading scale scored 48 knees as excellent, 30 as good, and 4 as fair. According to the MRI classification, 43 knees were no shift; 6, anterocentral shift; 15, posterocentral shift; and 12, central shift. Shift-type knees had a significantly larger number of peripheral tears, and repairs were performed in the shift-type knees (55%) more frequently than in the no-shift-type knees (28%). Among 82 knees, 31 were repaired simultaneously after a central partial meniscectomy. Conclusion: Magnetic resonance imaging classification provides more information to surgeons in choosing the appropriate treatment methods, although the final decision regarding procedure is made during arthroscopy after thorough analysis of the tear.

Background: Tears of the medial meniscus posterior horn (MMPH) are frequently found in knees with deficient anterior cruciate ligaments (ACLs). There are few studies that have evaluated healing of the menisci and the factors associated with healing. Hypothesis: The repaired menisci would show good healing in the knees with reconstructed ACLs, and the healing capacity of the menisci would differ according to the size, type, and location of the tear as well as the age and gender. Study Design: Case series; Level of evidence, 4. Methods: From August 1997 to February 2007, 311 knees underwent MMPH repair using either a modified all-inside or inside-out technique with concomitant ACL reconstruction. Among these patients, a second-look arthroscopy was performed at a mean of 37.7 months postoperatively (range, 12-128 months) in 140 patients. Clinical parameters and outcomes were evaluated. The repaired menisci were divided into complete, incomplete, and failure-to-heal groups. The factors associated with meniscal healing were statistically assessed. Results: Among 140 patients, 118 (84.3%) showed complete healing, 17 (12.1%) had incomplete healing, and 5 (3.6%) failed to heal. The clinical success rate was 96.4% (135/140) because patients in the incomplete group showed no clinical symptoms associated with meniscal tears. Healing was associated with the tear location (P < .001) and type of tear (P = .0237) on the univariate analysis and the location (P = .0401) only on the multivariate analysis. Conclusion: Repaired MMPH tears in knees with reconstructed ACLs healed without complications and had satisfactory clinical results. The tear location and type were factors associated with healing on the univariate analysis and location only on the multivariate analysis.

The number of primary anterior cruciate ligament reconstructions is increasing rapidly; the number of failing grafts and need for revision surgery have also risen. Revision anterior cruciate ligament reconstruction will produce similar results to those of primary reconstruction, and there may be different results according to graft materials. Case control study; Level of evidence, 3. Fifty-nine revision surgeries were performed at 1 institution between January 1997 and October 2005. Fifty-five patients (56 operations) were followed. The results of 117 patients (117 knees) treated with arthroscopic primary anterior cruciate ligament reconstruction using double-looped semitendinosus and gracilis autograft from September 2001 to November 2002 were also evaluated. Clinical and stability results between primary and revision anterior cruciate reconstruction were compared. For the revision surgery, 21 (37.5%) knees had revision reconstruction with previously unharvested ipsilateral double-looped semitendinosus and gracilis autograft. Twenty (35.7%) were bone-patellar tendon-bone allograft, and 15 (26.8%) were Achilles allograft. The details of the technique varied according to the original graft choice and the abnormality encountered. Concomitant procedures were necessary in 32 (57.1%) of 56 knees. Clinical and stability results according to the different graft materials were also compared. There were significant improvements in the scores for subjective, objective forms (P < .001), and stability (P < .001). However, the clinical results of revision surgery were inferior to primary reconstruction (P < .001), but as regards stability, the difference between primary and revision cases was not significant (P = .338). There was no difference in clinical and stability results in different groups of graft material (P = .160-.690). Revision anterior cruciate ligament reconstruction could improve clinical and stability results, but the clinical results Were inferior to those of primary reconstruction. This study also demonstrated that the success of the operation did not depend on the choice of graft materials.