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      Knee lesions with anterior cruciate ligament (ACL) tear in Iraqi adult males: arthroscopic findings

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          Abstract

          This cross-sectional study aimed at exploring the frequency and extent of knee joint lesions associated with delayed treatment of anterior cruciate ligament (ACL) injury. It enrolled 300 patients from 2020 to 2022 who were subjected to arthroscopy for anterior cruciate ligament reconstruction. The sample was comprised of Iraqi adult male patients from different regions of Iraq, and the surgical procedure was carried out in Al-Diwaniyah Teaching Hospital. The findings were recorded by Karl Storz’s camera system. Dissection and arthroscopy were done under general anesthesia using an anterolateral portal technique. The study employed a visualization of the anterior cruciate ligament probing the meniscus and reaching the posteromedial space for the ramp lesion. The mean age of patients was 28.05±6.92 years, ranging from 19 to 35 years and the mean duration from onset of injury to the time of operation was 3.69±1.07 years, ranging from 6 months to 10 years. The arthroscopic examination revealed medial meniscus tear in 80% of the cases, lateral meniscus tear in 40% of the cases, cartilage lesion in 40% of the cases, and meniscus ramp lesions in 10% of the cases. Most cases of ACL tear are associated with a meniscus injury, cartilage defect, and collateral ligament tear. These serious lesions, such as complex meniscus tears or full articular cartilage defects, are a direct consequence of delayed treatment. Consequently, it is crucial to inform the patients about the significant issues that can arise due to treatment delays.

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          Anterior Cruciate Ligament Injury Risk in Sport: A Systematic Review and Meta-Analysis of Injury Incidence by Sex and Sport Classification

          To evaluate sex differences in incidence rates (IRs) of anterior cruciate ligament (ACL) injury by sport type (collision, contact, limited contact, and noncontact). A systematic review was performed using the electronic databases PubMed (1969–January 20, 2017) and EBSCOhost (CINAHL, SPORTDiscus; 1969–January 20, 2017) and the search terms anterior cruciate ligament AND injury AND ( incidence OR prevalence OR epidemiology ). Studies were included if they provided the number of ACL injuries and the number of athlete-exposures (AEs) by sex or enough information to allow the number of ACL injuries by sex to be calculated. Studies were excluded if they were analyses of previously reported data or were not written in English. Data on sport classification, number of ACL injuries by sex, person-time in AEs for each sex, year of publication, sport, sport type, and level of play were extracted for analysis. We conducted IR and IR ratio (IRR) meta-analyses, weighted for study size and calculated. Female and male athletes had similar ACL injury IRs for the following sport types: collision (2.10/10 000 versus 1.12/10 000 AEs, IRR = 1.14, P = .63), limited contact (0.71/10 000 versus 0.29/10 000 AEs, IRR = 1.21, P = .77), and noncontact (0.36/10 000 versus 0.21/10 000 AEs, IRR = 1.49, P = .22) sports. For contact sports, female athletes had a greater risk of injury than male athletes did (1.88/10 000 versus 0.87/10 000 AEs, IRR = 3.00, P < .001). Gymnastics and obstacle-course races were outliers with respect to IR, so we created a sport category of fixed-object, high-impact rotational landing (HIRL). For this sport type, female athletes had a greater risk of ACL injury than male athletes did (4.80/10 000 versus 1.75/10 000 AEs, IRR = 5.51, P < .001), and the overall IRs of ACL injury were greater than all IRs in all other sport categories. Fixed-object HIRL sports had the highest IRs of ACL injury for both sexes. Female athletes were at greater risk of ACL injury than male athletes in contact and fixed-object HIRL sports.
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            Joint Instability and Osteoarthritis

            Joint instability creates a clinical and economic burden in the health care system. Injuries and disorders that directly damage the joint structure or lead to joint instability are highly associated with osteoarthritis (OA). Thus, understanding the physiology of joint stability and the mechanisms of joint instability-induced OA is of clinical significance. The first section of this review discusses the structure and function of major joint tissues, including periarticular muscles, which play a significant role in joint stability. Because the knee, ankle, and shoulder joints demonstrate a high incidence of ligament injury and joint instability, the second section summarizes the mechanisms of ligament injury-associated joint instability of these joints. The final section highlights the recent advances in the understanding of the mechanical and biological mechanisms of joint instability-induced OA. These advances may lead to new opportunities for clinical intervention in the prevention and early treatment of OA.
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              Return to Play and Patient Satisfaction After ACL Reconstruction: Study with Minimum 2-Year Follow-up.

              Return to play and patient satisfaction after anterior cruciate ligament reconstruction (ACLR) have been inconsistently studied. The purposes of this study were to (1) investigate rates and predictors of return to play after ACLR, (2) evaluate patient satisfaction after ACLR, and (3) analyze the relationship between return to play and satisfaction with the result of ACLR.
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                Author and article information

                Contributors
                https://orcid.org/0000-0002-8040-814X
                Journal
                J Med Life
                J Med Life
                JMedLife
                Journal of Medicine and Life
                Carol Davila University Press (Romania )
                1844-122X
                1844-3117
                September 2023
                : 16
                : 9
                : 1335-1337
                Affiliations
                [1 ]Department of Surgery, College of Medicine, University of Al-Qadisiyah, Al Diwaniyah, Iraq
                Author notes
                [* ] Corresponding Author: Iskandar Mahdi Alardi, Department of Surgery, College of Medicine, University of Al-Qadisiyah, Al Diwaniyah, Qadisiyyah Province, Iraq. E-mail: iskandarmahdi@ 123456yahoo.com
                Article
                JMedLife-16-1335
                10.25122/jml-2023-0055
                10719793
                38107704
                c87269f1-73a7-45e9-8960-ea78dd229a3b
                ©2023 JOURNAL of MEDICINE and LIFE

                This open access article is licensed under Creative Commons Attribution 4.0 International (CC BY 4.0). http://creativecommons.org/licenses/by/4.0

                History
                : 05 March 2023
                : 05 July 2023
                Categories
                Original Article

                Medicine
                acl-associated injuries,arthroscopy,anterior cruciate ligament injury,aclr: anterior cruciate ligament reconstruction,acl: anterior cruciate ligament,mcl: medial collateral ligament,lcl: lateral collateral ligament

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