Associated medial meniscal injury in the setting of ACLR leads to increased ATT at 24-month follow-up. Furthermore, isolated anatomic ACLR in the absence of meniscal injury demonstrated no significant difference from native knee kinematics at 24-month follow-up during rigorous "high demand" knee activity with the current sample size. Patients undergoing anatomic ACLR in the presence of medial meniscal injury remained at a higher likelihood of sustaining altered long-term knee kinematics.

» The tibial slope represents an important risk factor for both primary anterior cruciate ligament (ACL) injury and subsequent reconstruction failure.» A high tibial slope has been associated with increased anterior tibial translation, increased strain on the ACL, and increased posteromedial compartment contact pressure.» Patients with ACL-deficient knees who also have coronal tibiofemoral malalignment may potentially benefit from concomitant high tibial osteotomy and ACL reconstruction.» Understanding the impact of the tibial slope on ACL reconstruction outcomes and the treatment options with regard to coronal tibiofemoral alignment allows for the appropriate care of patients with both morbidities.

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F acial nerve schwannomas (FNSs) are rare tumors accounting for 1.9% of all intracranial neuromas and 0.8% of intrapetrous tumors.1 FNS can arise from any segment of the facial nerve, starting at its origin in the cerebellopontine angle and extending to its extracranial components.2 While such neuromas can mimic the radiographic features of the more common vestibular schwannoma, patients with FNS typically present with signs and symptoms of facial nerve dysfunction.The optimal management strategy for FNS patients abbreviatioNs FNS = facial nerve schwannoma; GKRS = Gamma Knife radiosurgery; NAGKC = North American Gamma Knife Consortium; SRS = sterotactic radiosurgery. obJect Facial nerve schwannomas (FNSs) are rare intracranial tumors, and the optimal management of these tumors remains unclear. Resection can be undertaken, but the tumor's intimate association with the facial nerve makes resection with neurological preservation quite challenging. Stereotactic radiosurgery (SRS) has been used to treat FNSs, and this study evaluates the outcome of this approach. methods At 8 medical centers participating in the North American Gamma Knife Consortium (NAGKC), 42 patients undergoing SRS for an FNS were identified, and clinical and radiographic data were obtained for these cases. Males outnumbered females at a ratio of 1.2:1, and the patients' median age was 48 years (range 11-76 years). Prior resection was performed in 36% of cases. The mean tumor volume was 1.8 cm 3 , and a mean margin dose of 12.5 Gy (range 11-15 Gy) was delivered to the tumor. results At a median follow-up of 28 months, tumor control was achieved in 36 (90%) of the 40 patients with reliable radiographic follow-up. Actuarial tumor control was 97%, 97%, 97%, and 90% at 1, 2, 3, and 5 years postradiosurgery. Preoperative facial nerve function was preserved in 38 of 42 patients, with 60% of evaluable patients having HouseBrackmann scores of 1 or 2 at last follow-up. Treated patients with a House-Brackmann score of 1 to 3 were more likely to demonstrate this level of facial nerve function at last evaluation (OR 6.09, p = 0.006). Avoidance of temporary or permanent neurological symptoms was more likely to be achieved in patients who received a tumor margin dose of 12.5 Gy or less (log-rank test, p = 0.024) delivered to a tumor of ≤ 1 cm 3 in volume (log-rank test, p = 0.01). coNclusioNs Stereotactic radiosurgery resulted in tumor control and neurological preservation in most FNS patients. When the tumor is smaller and the patient exhibits favorable normal facial nerve function, SRS portends a better result. The authors believe that early, upfront SRS may be the treatment of choice for small FNSs, but it is an effective salvage treatment for residual/recurrent tumor that remain or progress after resection.

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