Peter Annear

Peter Annear
Perth Orthopaedic and Sports Medicine Centre, Perth ,Western Australia

FRACS (Orth)

About

97
Publications
21,598
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1,241
Citations
Citations since 2016
83 Research Items
630 Citations
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120
2016201720182019202020212022020406080100120

Publications

Publications (97)
Presentation
Full-text available
Soft tissue patella tendon distalisation in the skeletally immature patient: A new technique and case series Abstract Purpose: Adolescents with patella alta are at increased risk of patella dislocation and instability. This study aims to demonstrate the safety and efficacy of addressing alta and instability in skeletal immaturity with a new techni...
Conference Paper
Full-text available
Introduction & Aims: Rehabilitation after anterior cruciate ligament reconstruction (ACLR) is considered crucial in restoring strength and functional deficits. Lingering objective deficits, often evaluated via isokinetic dynamometry and functional hop capacity, are associated with an increased risk of re-injury upon return to sport (RTS). This stud...
Conference Paper
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We have recently reported on the 2 year outcomes of partial ACLR. In this presentation we focus on the specific surgical technique in performing a partial ACL reconstruction.
Conference Paper
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Abstract Title A prospective clinical evaluation of paediatric patients with open growth plates undergoing anterior cruciate ligament reconstruction combined with lateral extra-articular tenodesis. Authors PETER ANNEAR MD, FRACS1 Salar Sobhi MD1 Jay Ebert PhD2,3 1 Perth Orthopaedic and Sports Medicine Centre, 31 Outram Street, West Perth, Weste...
Article
Background Lower limb strength asymmetry is associated with re-injury after anterior cruciate ligament reconstruction (ACLR). This study investigated limb symmetry indices (LSIs) during isokinetic knee extensor and flexor assessment after ACLR. Methods Overall, 25 patients underwent isokinetic knee extensor and flexor strength assessment, 9–12 mon...
Article
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Background Few studies have reported the return-to-sports (RTS) rate in patients after augmentation of autologous anterior cruciate ligament reconstruction (ACLR) with the Ligament Augmentation and Reconstruction System (LARS). Purpose/Hypothesis The purpose of this study was to compare postoperative outcomes in patients who underwent ACLR with si...
Presentation
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teaching lecture for medical students
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discussing possible nerve injury with proximal hamstring surgery
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Recurrent patella instability is common in skeletally immature patients. For over ten years we have been performing a surgical technique of MPFL reconstruction using two gracilis limbs as graft. The Graft is looped though the MCL origin and each limb is then fixed to the patella at two separate points on the superficial surface of the patella. The...
Conference Paper
Full-text available
Anterior Cruciate Ligament injury is increasingly common in younger patients.The Surgical and non-surgical treatments offer different challenges. An overview of the indications, risks and techniques for managing these younger patients.Operative and non-operative treatments need to be individually tailored based on the patient and injury characteris...
Article
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The paper compares hamstring autograft with a "hybrid" graft of hamstrings and a small LARS ligament in ACL reconstruction patients. The paper concludes ACLR utilizing a hybrid autologous/LARS® construct facilitated accelerated rehabilitation without evidence of increased failure or early graft stretch. Additionally, there was no clinical differenc...
Article
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Introduction: Understanding factors that cause loss of extension post Anterior Cruciate Ligament (ACL) reconstruction may assist surgeons in preventing this problem. The aim of this clinical trial is to determine the effect of reconstructed ACL graft size on postoperative range of motion in ACL reconstruction in human subjects. Methods: This therap...
Conference Paper
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TITLE: 7-10 year comparison of clinical and MRI-based outcomes after double bundle hamstrings or hamstrings/LARS hybrid anterior cruciate ligament reconstruction. ABSTRACT Background: A high rate of re-tear exists after primary anterior cruciate ligament reconstruction (ACLR), and lower limb strength and functional symmetry is considered imperat...
Conference Paper
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Purpose The anterior cruciate ligament (ACL) is the primary structure that provides knee joint stability. The function of the ACL is to limit excessive anterior displacement during movement. Thus, an ACL rupture can lead to instability, dysfunctional biomechanics, a higher probability of meniscus injury and future osteoarthritis (OA) [1]. The preva...
Article
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Background: Anterior cruciate ligament reconstruction (ACLR) has a high incidence of re-tear in younger patients. Despite comparable functional outcomes, the incidence of re-tear using single and double bundle ACLR methods has not been well reported. Aim: To hypothesize that double bundle hamstring ACLR has a lower graft rupture rate compared wi...
Article
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Abstract CONTEXT: The importance of rehabilitation and evaluation prior to return to sport (RTS) in patients undergoing anterior cruciate ligament reconstruction has been reported. OBJECTIVE: This study sought to investigate current perspectives of Australian orthopedic surgeons on rehabilitation and RTS evaluation. DESIGN: Survey. PARTICIPANTS: Me...
Presentation
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PCL injuries in the paediatric population, a literature of techniques and outcomes
Article
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Context: The importance of rehabilitation and evaluation prior to return to sport (RTS) in patients undergoing anterior cruciate ligament reconstruction has been reported. Objective: This study sought to investigate current perspectives of Australian orthopedic surgeons on rehabilitation and RTS evaluation. Design: Survey. Participants: Memb...
Presentation
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Comparison of ACL Hybrid graft stiffness: A porcine biomechanical study
Presentation
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Graft rupture rates in <20 yr olds �undergone double bundle hamstring ACL reconstructions An investigation of the high rates of graft failure in younger patients and the affect of double bbundle hamstring ACLR on the failure rates in this age group.
Conference Paper
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Background: ACL tears are common, though partial injuries have been described that may still restrict the return of patients to sporting activities due to a persistent sensation of knee instability. This study sought to determine the outcome of partial bundle ACLR using autologous hamstrings.
Presentation
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TITLE: Partial bundle anterior cruciate ligament reconstruction using autologous hamstrings ABSTRACT Background: ACL tears are common, though partial injuries have been described that may still restrict the return of patients to sporting activities due to a persistent sensation of knee instability. This study sought to determine the outcome of p...
Presentation
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TITLE: Anterior cruciate ligament reconstruction using autologous hamstrings augmented with LARS provides good clinical scores, high levels of satisfaction and return to sport and a low re-tear rate at 2 years ABSTRACT Background: A number of surgical methods exist in undertaking anterior cruciate ligament reconstruction (ACLR), though relatively...
Article
Full-text available
Background There are a number of surgical methods for undertaking anterior cruciate ligament (ACL) reconstruction (ACLR), although relatively high rates of ipsilateral retears and contralateral tears exist, with only 65% of patients returning to their preinjury level of sport. ACLR techniques adopting synthetic augmentation have been proposed in an...
Article
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Purpose For recurrent lateral patellar instability surgical algorithm, an arthroscopic assessment of patellar tracking can aid with the decision of adding a tibial tubercle transfer procedure based on knee flexion angle at which patella centrally engages in its groove. Tibial tubercle–trochlear groove distance is variable in normal values and has d...
Preprint
Full-text available
The paper is a chart review of 626 cases comparing hybrid (Lars and hamstring) vv all hamstring ACL grafts. Failure and re-operation rates are compared .
Article
Objectives: To investigate views and practices of Australian therapists on rehabilitation and return to sport (RTS) after anterior cruciate ligament reconstruction (ACLR). Design: Survey-based study. Setting: Online survey platform. Participants: Australian Physiotherapists and Accredited Exercise Physiologists (n = 223). Main outcome measures: 1)...
Article
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Purpose To report outcomes following proximal hamstring reconstruction employing an ipsilateral distal hamstring tendon autograft, in patients with chronic proximal ruptures. Methods Six patients presenting with a chronic proximal hamstring avulsion and a medial time from injury of 11.0 months (range 7–18), confirmed via magnetic resonance imaging...
Presentation
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This study documented the current perspectives on rehabilitation and RTS evaluation of Australian orthopaedic surgeons within the Australian Knee Society (AKS).
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The paper reports comparative outcomes including return to sport testing of hybrid and hamstring ACL reconstructions.
Presentation
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The presentation reports the comparative outcomes of hybrid and hamstring graft ACLR. at 7-10 years looking at graft failure, re-operations and MRI WORMS score for osteoarthritis.
Article
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Objectives: – A plethora of evidence-based research is emerging on the benefits of rehabilitation following anterior cruciate ligament reconstruction (ACLR), as well as the timing of return to sport (RTS) and importance of patient evaluation prior to RTS discharge. This study documented the current perspectives on rehabilitation and RTS evaluation...
Conference Paper
Full-text available
Background: A high rate of re-tear exists after primary anterior cruciate ligament reconstruction (ACLR), and lower limb strength and functional symmetry is considered imperative in minimizing the risk of re-tear. There are also concerns about the development of post-operative complications and early degenerative changes after ACLR surgery. Several...
Conference Paper
Full-text available
TITLE: Anterior cruciate ligament reconstruction with single bundle hamstrings versus hamstrings augmented with synthetic LARS: An early comparison of patient outcomes. ABSTRACT Background: A high rate of re-tear exists after primary anterior cruciate ligament reconstruction (ACLR), and lower limb strength and functional symmetry is considered i...
Article
Full-text available
Purpose Delayed ligamentization following anterior cruciate ligament reconstruction (ACLR) may result in reduced graft stiffness and strength, and an increased risk of secondary re-tear. Remnant sparing ACLR may accelerate ligamentization and proprioceptive function, theoretically reducing re-injury risk. This study sought to investigate 10-year gr...
Article
Full-text available
Background Preventing and mitigating the risk of reinjury after anterior cruciate ligament reconstruction (ACLR) rest on variables including age, surgical restoration of knee stability, adequate physical function, and thorough and complete postoperative rehabilitation, but to what degree these factors influence return to sport is unclear. Purpose...
Presentation
Full-text available
Objectives: The primary purpose of this study is to determine whether or not a partial Anterior Cruciate Ligament (ACL) reconstruction with accelerated rehabilitation produced similar outcomes to that of the conventional ACL reconstruction with its traditional rehabilitation program timeframe. An improved understanding of these outcomes can change...
Presentation
Delayed Diagnosis in Proximal Hamstring rupture Nicholas Gormack, Peter Annear Introduction & aims – Proximal hamstring tendon avulsion is a significant injury which if untreated can lead to significant morbidity. Early surgery is associated with improved patient outcomes and lower complication rates. However delayed diagnosis remains a common pr...
Presentation
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a review of my personal approach to ACLR revision surgery
Presentation
The paper discusses a measured approach to the various patelofemoral problems that may warrant a surgical solution.
Presentation
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Objectives: Since 2008, we have offered patients Hybrid ACL (hamstring plus LARS ligament) graft or double bundle hamstring graft. We allow the patients with Hybrid ACL to jog at 2 months and return to sports at 6 months. In comparison we allow the double bundle hamstring group to jog at 4 months and return to sports at 12 months. We considered the...
Presentation
Full-text available
Objectives: A major reason for undergoing anterior cruciate ligament reconstruction (ACLR) for patients is to return to high demand activity and sport. Published literature supports a return to sport (RTS) at 6-12 months, though the recovery of lower limb strength and functional symmetry is critical and is linked with a patient’s ability to RTS, a...
Presentation
Full-text available
The Paper discusses the theory of augmented hamstring grafts with small prosthetic PET material(LARS). The paper reports advantages in earlier return to rehabilitation levels, better 12 month objective scores as well as 4-8 year comparable graft failure rates. The double bindle Hybrid graft configuration however had higher re-operation rates. Our c...
Presentation
Full-text available
The presentation looks at double bundle hamstring ACL reconstruction in the younger age group (<20 yrs) and wether this can reduce the reportedly high failure rates in this group. While not statistically significant the failure rate at minimum of 2 years follow-up of 11% compares favourably with 18% reported in the Webster et al (2016) paper. Large...
Presentation
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The presentation reviews the advantages and disadvantages of retaining the remnant in ACLR. It reports 10 year follow-up of an RCT of sparing vv debridement of the remnant. The remnant sparing techniques are described. The relationship of time of graft re-rupture and graft healing is considered.
Conference Paper
Full-text available
Delayed Diagnosis in Proximal Hamstring rupture Nicholas Gormack, Peter Annear Introduction & aims – Proximal hamstring tendon avulsion is a significant injury which if untreated can lead to significant morbidity. Early surgery is associated with improved patient outcomes and lower complication rates. However delayed diagnosis remains a common pr...
Conference Paper
Full-text available
Introduction and Aims (50 words): Background: Anterior cruciate remnant preservation may be beneficial in Anterior Cruciate Ligament Reconstruction (ACLR). Gohil, Annear & Breidahl (Sept, 2007) used a grade 1 randomised controlled trial to compare the two methods and at short term follow-up, the minimal debridement technique demonstrated earlier r...
Article
Full-text available
Isolated popliteal tendon avulsions are rare injuries with less than 20 cases reported in the literature. Clinical suspicion of injury is aided by MRI findings. Due to the paucity of literature there is a lack of consensus as to the best management for such injuries. Both non-operative and operative treatment options have been reported to be succes...
Article
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The Hybrid Anterior Cruciate Ligament Reconstruction Surgical Technique Does Permit An Accelerated Early Functional Recovery And Return To Sport. Peter Annear1, Ebert Jay2 1 Perth Orthopaedic & Sports Medicine Centre, Perth, AUSTRALIA. 2 School of Sport Science, Exercise & Health, University of Western Australia, Perth, AUSTRALIA. A major reason f...
Presentation
Full-text available
The study was a biomechanical comparison of 3 ACL graft types- four strand tendons, four strand tendons with LARS augmentation and four strand tendons with FibreTape augmentation. The tendons were freshly harvested porcine flexors. Both Hybrid constructs had greater stiffness than the tendons alone. Both hybrid constructs demonstrated changes in bi...
Conference Paper
Full-text available
Background Anterior cruciate ligament (ACL) reconstruction is one of the most common orthopaedic procedures performed in Australia. Often patients who require ACL reconstructions are active individuals who value early return to activity and sport. Synthetic grafts offer immediate stability which allows for rapid recovery and early mobilisation but...
Article
Full-text available
Abstract PURPOSE: Avulsion of the proximal hamstring tendons is an uncommon injury. To date, few studies have prospectively evaluated outcomes of surgical repair. The aim of the present study is to review the functional outcomes of surgical repair of proximal hamstring tendon avulsions. METHODS: This is a prospective series of 96 consecutive proxim...
Article
Constriction of the lower limb by a congenital amniotic band has been proposed to explain the development of pseudoarthrosis of the tibia and fibula. We report a case of amniotic band syndrome in a preterm female infant with pseudoarthrosis of the tibia and fibula. She was born at 29 weeks of gestation with congenital amniotic bands and was noted t...
Article
Constriction of the lower limb by congenital amniotic band has been proposed to explain the development of pseudoarthrosis of tibia and fibula. We report a case of amniotic band syndrome in a preterm infant with pseudoarthrosis of tibia and fibula. Simple release of constriction band with Z-plasty resulted in the growth of mature bone, replacing th...
Article
Full-text available
Objectives Since 2008, we have offered patients Hybrid ACL (hamstring plus LARS ligament) graft or double bundle hamstring graft. We allow the patients with Hybrid ACL to jog at 2 months and return to sports at 6 months. In comparison we allow the double bundle hamstring group to jog at 4 months and return to sports at 12 months. We considered the...
Article
Full-text available
Objectives Surgical management of patellar instability includes proximal realignment procedure such as MPFL reconstruction. The decision to add a distal realignment procedure of tibial tubercle transfer is based on severity of patellar instability judged on either TTTG distance or arthroscopic patellofemoral tracking. We set out to validate our use...
Article
Full-text available
Objectives A major reason for undergoing anterior cruciate ligament reconstruction (ACLR) for patients is to return to high demand activity and sport. Published literature supports a return to sport (RTS) at 6-12 months, though the recovery of lower limb strength and functional symmetry is critical and is linked with a patient’s ability to RTS, as...
Article
Full-text available
Objectives Surgical management of patellar instability includes proximal realignment procedure such as MPFL reconstruction. The decision to add a distal realignment procedure of tibial tubercle transfer is based on severity of patellar instability judged on either TTTG distance or arthroscopic patellofemoral tracking. We set out to validate our use...
Article
Full-text available
PurposeAvulsion of the proximal hamstring tendons is an uncommon injury. To date, few studies have prospectively evaluated outcomes of surgical repair. The aim of the present study is to review the functional outcomes of surgical repair of proximal hamstring tendon avulsions. Methods This is a prospective series of 96 consecutive proximal hamstring...
Article
Full-text available
Purpose: Rupture of the anterior cruciate ligament (ACL) is a common and debilitating injury that impacts significantly on knee function and risks the development of degenerative arthritis. The outcome of ACL surgery is not monitored in Australia. The optimal treatment is unknown. Consequently, the identification of best practice in treating ACL i...
Article
Full-text available
Background: Tibial tubercle transfer (TTT) and medial patellofemoral ligament (MPFL) reconstruction have both shown, either in isolation or in combination, to provide improved patellofemoral joint (PFJ) stability. There are few studies that provide evidence that this remains true in the long term. Purpose: To compare the long-term results of pat...
Article
Full-text available
Purpose: The purpose of this study is to examine the outcomes of a cohort of patients who have undergone a new surgical technique for anterior cruciate ligament (ACL) tunnel targeting using the footprint of the torn ACL as soft tissue markers. This is in the setting of anatomical ACLR with remnant preservation. Methods: This retrospective single ce...
Article
Full-text available
Purpose: The purpose of the present study was to validate a new scoring system for proximal hamstring injury-the Perth Hamstring Assessment Tool (PHAT). Methods: This is a prospective series of 74 consecutive proximal hamstring surgical repairs in 72 patients, with a median age of 50.5 years (range 16-74). Patients completed the PHAT, SF12 Healt...
Article
Full-text available
Purpose: This prospective case series is designed to determine the 2-year clinical and radiological outcomes of patients undergoing an ACL reconstruction using the ligament augmentation reconstruction system (LARS) 133 prosthesis as an augmentation device for a 4-tunnel autologous hamstrings graft, in the context of accelerated rehabilitation. Meth...
Article
Full-text available
Objectives: The primary purpose of this study is to determine whether or not a partial Anterior Cruciate Ligament (ACL) reconstruction with accelerated rehabilitation produced similar outcomes to that of the conventional ACL reconstruction with its traditional rehabilitation program timeframe. An improved understanding of these outcomes can change...
Article
Full-text available
Background Anterior cruciate remnant preservation may be beneficial in Anterior Cruciate Ligament Reconstruction (ACLR). Gohil, Annear & Breidahl (Sept, 2007) used a grade 1 randomised controlled trial to compare the two methods and at short term follow-up, the minimal debridement technique demonstrated earlier revascularisation within the ACL graf...
Article
Full-text available
Purpose: Reconstruction of the medial patellofemoral ligament (MPFL) is increasingly used to restore the primary ligamentous restraint to patella dislocation. The purpose of this randomised controlled trial is to compare the 5 year results of the addition of autograft MPFL reconstruction to tibial tubercle transfer (TTT) and lateral release (LR) (r...
Article
Full-text available
Background: Multiple algorithms exist for proximal and/or distal stabilisation surgery for patellar instability with no consensus in the literature. Aim: To validate our surgical algorithm based on patellofemoral congruence for patellar instability. Algorithm: Once patellar stabilization surgery is clinically indicated, we determine patellofemora...
Article
Full-text available
This investigation looked at functional outcomes, following a novel technique of surgical repair using table staples. Patients underwent surgery for proximal hamstring rupture with table staples used to hold the tendon reapproximated to the ischial tuberosity. Functional outcomes following surgery were assessed. We also used a combined outcome asse...
Article
Full-text available
Purpose ‘Clinical cyclops syndrome’ is associated with pain and a palpable ‘clunk’ at terminal extension with the loss of full extension. The aims of this prospective controlled study were: (1) to assess whether the minimal debridement of the ACL stump and notch is associated with an increased incidence of clinical cyclops lesions, (2) to look at t...