• Home
  • Robert F LaPrade
Robert F LaPrade

Robert F LaPrade
Twin Cities Orthopedics

MD, PhD

About

720
Publications
639,151
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
27,484
Citations
Introduction
I am a complex knee and sports medicine surgeon and I practice at Twin Cities Orthopedics in Edina and Eagan, Minnesota. I have had an international collaboration with Lars Engebretsen MD, PhD and his group at the University of Oslo since 1997 on the study of complex knee injuries. I treat many types of complex knee injuries with surgical reconstructions-revision ACLR, double bundle PCLR, multiple ligament reconstructions, osteotomies, meniscal transplants, fresh osteoarticular allografts, trochleoplasties, and all types of complex meniscal repairs (roots, radial, ramp, and others) in professional, Olympic, collegiate and recreational athletes.
Additional affiliations
June 2019 - present
Twin Cities Orthopedics
Position
  • Complex Knee Surgeon
April 2010 - May 2019
Clinic
Position
  • Complex Knee Surgeon
April 2010 - December 2019
University of Minnesota Twin Cities
Position
  • Professor (Associate)
Education
August 1999 - June 2003
University of Oslo
Field of study
  • Philosophy (Posterolateral Knee Injuries)
August 1993 - July 1994
Hughston Sports Medicine Clinic
Field of study
  • Sports Medicine
June 1987 - June 1993
Michigan State University-Kalamazoo Center for Medical Studies
Field of study
  • Orthopaedic Residency

Publications

Publications (720)
Article
Full-text available
BACKGROUND Few existing studies have examined the relationship between lower extremity bone length and quadriceps strength. PURPOSE/HYPOTHESIS To evaluate the relationship between lower extremity, tibia and femur lengths, and isometric quadriceps strength in patients undergoing knee surgery. The null hypothesis was that there would be no correlati...
Article
Full-text available
Background The contribution of anterior cruciate ligament (ACL) injury to lateral instability under varus stress, particularly compared with posterolateral structures, is not well known. Purpose To investigate the effect of sectioning the ACL and posterolateral knee structures on lateral compartment gapping under varus stress. Study Design Contro...
Article
Proximal tibial osteotomies are an effective treatment option for addressing knee instability secondary to alignment-based overload on ligamentous structures. Proximal tibial osteotomies effectively alter the mechanical axis to redistribute forces across the knee, resulting in improved stability and overall function. Factors such as tibial slope an...
Article
The goal of osteotomies is to redistribute load within the affected joint, shifting forces from the pathologic knee compartments to contralateral, well-preserved areas, thereby improving symptoms and delaying the need for joint replacement. Proximal tibial osteotomy (PTO) is most commonly performed to treat varus malalignment of the knee whereas di...
Article
Full-text available
One of the anatomic variations observable within the knee joint is a reduction in the posterior curvature of the femoral metaphysis proximal to the medial femoral condyle. This curvature is usually concave enough to fit the posterior horn of the medial meniscus (PHMM) during full knee flexion. A reduction in curvature may result in posteromedial ti...
Article
Objectives Although the risk of tibial tunnel convergence in the setting of multiligament reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL), and medial and lateral meniscal root repair has not been defined. The purpose of this stud...
Article
Background: Tibiofemoral bone bruise patterns seen on magnetic resonance imaging (MRI) are associated with ligamentous injuries in the acutely injured knee. Bone bruise patterns in multiligament knee injuries (MLKIs) and particularly their association with common peroneal nerve (CPN) injuries are not well described. Purpose: To analyze the tibiofe...
Article
Background Medial meniscus posterior root (MMPR) injuries accelerate the progression of osteoarthritis. While partial meniscectomy was once considered the gold standard for treatment, meniscus root repair has become increasingly utilized with reported improvements in clinical and biomechanical outcomes. Purpose To perform a systematic review of bi...
Article
Full-text available
Background Increased posterior tibial slope (PTS) is a risk factor for anterior cruciate ligament (ACL) rupture and failure of ACL reconstruction (ACLR) grafts. Purpose The purpose was to conduct a systematic review of literature on PTS measurements and to conduct a meta-analysis of comparable PTS measurements based on a patient’s ACL status. It w...
Article
Full-text available
Background Anterior cruciate ligament (ACL) tears are often associated with other ligamentous injuries. The side-to-side difference in heel height can represent a valuable diagnostic tool in the setting of multiligamentous injuries. Purpose To assess in a cadaveric model how sequential sectioning of the static stabilizing structures of the knee (A...
Article
Background The effect of coronal plane alignment on the outcomes of repairs of the medial meniscus root remains unclear. Hypothesis Increased preoperative varus alignment is associated with higher failure rates and lower patient-reported outcomes (PROs) after isolated repair of the medial meniscus root. Study Design Case series; Level of evidence...
Article
Purpose To evaluate the accuracy and precision of postoperative coronal plane alignment using 3D printed patient specific instrumentation (PSI) in the setting of proximal tibial or distal femoral osteotomies. Methods A systematic review evaluating the accuracy of 3D-printed PSI for coronal plane alignment correcting knee osteotomies was performed....
Article
Meniscal tear patterns associated with anterior cruciate ligament (ACL) tears, such as root tears and ramp lesions are common but less easily recognized on magnetic resonance imaging (MRI) compared with a complete radial tear or a locked bucket-handle tear. Timely treatment of these tears improves outcomes in the setting of ACL reconstruction. Whil...
Article
In recent years, reconstruction of structures in the posteromedial and posterolateral corners of the knee has increased in popularity. While these procedures produce good objective and subjective patient outcomes, the increasing incidence of these procedures also results in a higher rate of complications. There is currently a paucity of literature...
Article
Injuries of the posterolateral corner of the knee have historically been difficult to treat. The primary stabilizers of the posterolateral corner include the fibular collateral ligament, popliteus tendon, and popliteofibular ligament. Proper treatment of these injuries requires complete clinical workup including stress radiographs, alignment imagin...
Article
Full-text available
Background: The biceps brachii (BB) muscle is one of the three muscles located in the anterior compartment of the of the arm. It insertion consists of two parts. The first part — main tendon — attached in the radial tuberosity and the second part — lacertus fibrosus (LF) — in the fascia of the forearm flexors.The intention of research was to reveal...
Article
Full-text available
Recurrent proximal tibiofibular joint (PTFJ) instability can result from nonanatomic repair using a suture button construct. During initial reconstruction, proper identification of anatomic landmarks is critical for proper placement of suture button construct components and successful patient outcomes. In cases of symptomatic recurrent instability,...
Article
Background Although the risk of tibial tunnel convergence in the setting of multiligamentous reconstruction has been reported in the literature, the risk of tunnel convergence in the setting of posterior cruciate ligament (PCL), anterior cruciate ligament (ACL) reconstruction and medial and lateral meniscus root repair has not been defined. Purpos...
Article
The purpose of this study was to characterize the morphological variations in the distal attachment of the popliteofibular ligament (PFL) and create an accurate classification for use in planning surgical procedures in this area and in evaluating radiological imaging. One hundred and thirty-seven lower limbs of body donors fixed in 10% formalin sol...
Article
Background: Although previous studies have reported good short-term results for superficial medial collateral ligament (sMCL) reconstruction, whether an augmented MCL repair is clinically equivalent remains unclear. Purpose/Hypothesis: The purpose of this study was to compare clinical outcomes between randomized groups that underwent sMCL augmenta...
Article
Full-text available
Osteochondral defects of the knee often occur as a result of traumatic injury, repetitive microtrauma, or genetic predisposition. Smaller lesions can be treated nonoperatively in younger patient populations; however, large symptomatic lesions require surgical intervention using a fresh osteochondral allograft transplant. Although osteochondral defe...
Article
Purpose To evaluate the efficacy of selective IL-1 inhibitor therapy in the reduction of posttraumatic osteoarthritis (PTOA) progression following knee ligament or meniscal injury. Methods A systematic review was conducted evaluating the disease-modifying efficacy of selective IL-1 inhibition in the setting of knee PTOA. Results The literature se...
Article
Full-text available
Multiligament knee injuries (MLKIs) are debilitating injuries that increasingly occur in young athletes. Return to sport (RTS) has historically been considered unlikely due to the severity of these injuries. Reporting in the literature regarding objective outcomes following MLKI, including RTS, is lacking, as are clear protocols for both rehabilita...
Article
Full-text available
According to current literature, 90% of knee ligament injuries involve the medial collateral ligament or the anterior cruciate ligament. In contrast to the medial collateral ligament, which regenerates relatively well, the anterior cruciate ligament demonstrates compromised healing. In the past, there were numerous studies in animal models that exa...
Article
Anterior cruciate ligament (ACL) tears are a common orthopaedic injury, particularly in athletic populations. Primary ACL reconstructions (ACLR) have fairly successful outcomes; however, there is a subset of patients who experience failure or re-injury and require a technically challenging revision ACLR procedure. Knowledge of the clinically releva...
Chapter
Medial collateral ligament and posteromedial corner knee injuries are among the most frequently diagnosed conditions in sports medicine. These injuries can cause medial knee pain, side-to-side instability, and lead to secondary damage to both cruciate ligaments and articular cartilage. Understanding the anatomy and native healing properties of the...
Chapter
There is a paucity in the orthopedic literature regarding the use of cell therapies for ligament injuries. A majority of the existing literature on this topic is preclinical, considers small case series, or comprises anecdotal, editorial-type articles, with limited long-term clinical outcomes, mainly on the anterior cruciate ligament (ACL). At this...
Article
Full-text available
Patellofemoral instability is due to a combination of bony and soft tissue factors. While recurrent patellar dislocations are rare, evaluation and treatment of these conditions require addressing patellar height and lateralization of the tibial tubercle (TT), restraint to lateral patellar subluxation, and trochlear dysplasia. Other factors to consi...
Article
Full-text available
Multiligament knee injuries are complex injuries that must be addressed with a comprehensive diagnostic workup and treatment plan. Multiligament injuries are commonly observed with concomitant meniscal, chondral, and neurovascular injuries, requiring a thorough clinical assessment and radiographic evaluation. Due to the higher failure rates associa...
Article
Full-text available
Purpose The purpose of this study was to evaluate the main focus areas for research and development for furthering the state of meniscus science in 2021. Methods An electronic survey including 10 questions was sent in a blind fashion to the faculty members of the 5 th International Conference on Meniscus Science and Surgery . These faculty served...
Article
Meniscal root repairs are susceptible to unrecoverable loosening that may displace the meniscus from the initial position reduced during surgery. Despite this, the effects of a loosened meniscal root repair on knee mechanics are unknown. We hypothesized that anatomic root repairs without loosening would restore knee mechanics to the intact conditio...
Article
Full-text available
Decreased posterior tibial slope has been associated with increased risk of graft failure and knee instability after posterior cruciate ligament (PCL) reconstruction. Premature physeal arrest at the tibial tubercle is a common cause of osseous genu recurvatum. Surgical management is recommended to correct the tibial slope and prolong the integrity...
Article
A foundational knowledge of the anatomy and biomechanics of meniscal root tears is warranted for proper repair of meniscal root tears and for preventing some of their commonly described iatrogenic causes. Meniscal root tears are defined as either a radial tear occurring within one cm of the root attachment site of the meniscus or a complete bony or...
Article
Full-text available
The posterior cruciate ligament (PCL) is the primary stabilizer to posterior tibial translation of the knee. PCL injuries classically occur as the result of a posteriorly directed force against the anterior part of the tibia. They frequently occur as multiligament injuries or with concomitant cartilage or meniscal injuries. The posterior drawer tes...
Article
Full-text available
Background: Multiple ligament injuries of the knee occur in a variety of settings, often from athletic activities. Multiple cruciate and collateral ligament injuries may be associated with hamstring tendon rupture, common peroneal nerve (CPN) injury, meniscus, bone, and cartilage damage. Indications: After evaluation for concomitant life-threatenin...
Article
Multiple knee ligament injuries are defined as a disruption of any combination of the four main ligament complexes; the cruciate ligaments, posterolateral corner, and posteromedial corner. Evaluation requires consideration of the entire clinical picture, including injury to associated structures, directions and degree of instability, neurovascular...
Article
Full-text available
Storing platelet-rich plasma (PRP) for future use is a compelling approach, presuming the retention of biological properties is maintained. However, certain factors in PRP preparations have deleterious effects for the treatment of certain musculoskeletal conditions. The purpose of this study was to measure and compare matrix metalloproteinase prote...
Article
Full-text available
Objectives Anteromedial (AM) femoral tunnel positioning in anterior cruciate ligament reconstruction (ACLR) has been reported by some authors to yield superior clinical and functional outcomes compared to the transtibial (TT) approach; however, differences in the subsequent rates of post-traumatic osteoarthritis (PTOA) incidence are not clear. To p...
Article
PurposeDespite increasing interest in utilizing quadriceps tendon (QT) grafts in anterior cruciate ligament reconstruction (ACLR), data on the optimal quadriceps graft thickness are limited. The purpose of this study was to characterize the mechanical properties for the quadriceps tendon, comparing full-thickness (FT) QT grafts with and without bon...
Article
Full-text available
Posterior medial meniscus root tears (PMMRTs) make up a relatively notable proportion of all meniscus pathology and have been definitively linked to the progression of osteoarthritis (OA). While known risk factors for development of OA in the knee include abnormal tibial coronal alignment, obesity and female gender, PMMRTs have emerged in recent ye...
Chapter
Meniscal injuries are increasingly being recognized as significant musculoskeletal pathologies that often lead to detrimental effects on the long-term health of the knee joint. The menisci have several crucial functions for maintaining proper joint functioning, including load transmission, articular cartilage protection, and knee stability among ot...
Article
Blood flow restriction (BFR) training continues to look promising to try and maintain muscle mass or to rebuild muscle mass and strength after injury or surgery. Because additional potential benefits include pain control, increased gene expression (leading to atrophy reduction), and muscle excitation, our use of the modality favors earlier over mid...
Article
Full-text available
Anterior cruciate ligament reconstruction (ACLR) failure is multifactorial, but it is known that increased posterior tibial slope (PTS) leads to a greater likelihood of ACLR failure. This technical note describes the senior author’s technique for performing an anterior closing wedge proximal tibial osteotomy, in which the osteotomy is made proximal...
Article
Full-text available
The posterior cruciate ligament surgery invariably demands adequate posterior compartment visualisation and instrumentation. The addition of posteromedial (PM) portal during posterior cruciate ligament (PCL) surgeries remains essential. The further addition of one more proximal posteromedial (PM) portal further enhances the instrumentation includin...
Article
Full-text available
Background A detailed understanding of the anatomy of the quadriceps tendon (QT) is clinically relevant, owing to its increased use as a graft in anterior cruciate ligament reconstruction. Purpose To qualitatively and quantitatively describe the anatomy of the QT in younger adult specimens. Study Design Descriptive laboratory study. Methods A to...
Article
Full-text available
Objectives To evaluate the self-reported incidence of sleep disturbances, defined as ≤7 hours of sleep per 24-hour period, in patients undergoing arthroscopic-assisted knee surgery. Methods Patients who underwent arthroscopic knee surgery over the course of a 4-month period were prospectively included. Patients were excluded if a history of insomn...
Article
Full-text available
The purpose of this study was to characterize the morphological variations in the proximal attachments and create an accurate classification of the PPM for use in planning surgical procedures in this area, for evaluating radiological imaging and rehabilitation. One hundred and thirty-four lower limbs of body donors (52 woman and 82 man) fixed in 10...
Article
Background Previous meta-analyses have demonstrated superior outcomes in patients undergoing arthroscopic repair of medial meniscus posterior root tears (MMPRTs) compared with meniscectomy. However, these analyses have considered only short- or midterm outcomes and low-quality evidence. Purpose To compare the mid- to long-term rates of radiographi...
Article
PurposeTo assess the recovery of extension and improvement in functional scores after an arthroscopic or open posterior knee capsulotomy in the setting of an extension deficit.MethodsA systematic search of articles published between 1980 and 2020 was performed in the MEDLINE/PubMed database, EMBASE/Ovid database and Web of Science database. The inc...
Article
Reconstruction of the anterior cruciate ligament (ACL) is one of the most common surgical procedures in orthopaedic sports medicine. Despite this, graft selection remains controversial with various regional, institutional, and individual preferences and trends. The traditional autograft options for reconstruction have been hamstring tendon and bone...
Article
Case: The authors present a case of a 41-year-old woman who was treated for a chronic type 2 posterior horn tear of the medial meniscal root. During an arthroscopic repair, a broad, thick ligament coursing through the intercondylar notch caused difficulty in visualizing the posterior joint space and necessitated creation of an accessory portal. Gi...
Article
Patients with multiligament knee injuries require a thorough examination (Lachman, posterior-drawer, varus, valgus, and rotational testing). Diagnoses are confirmed with magnetic resonance imaging as well as stress radiographs (posterior, varus, and valgus) when indicated. Multiple systematic reviews have reported that early (<3 weeks after injury)...
Article
Full-text available
Background: Using Platetet-Rich Plasma (PRP) in anterior cruciate ligament reconstruction (ACLR) has been suggested to improve patient outcomes. The aim of this study was to assess the impact of PRP administration on pain, range of motion (ROM) restoration and the functional results of ACLR performed with quadriceps tendon bone (QTB) autografts. Me...
Article
Full-text available
The purpose of this study is to review the surgical methods of enhancing anterior cruciate ligament (ACL) graft maturation. Several methods of ACL maturation enhancement were identified through research of the literature available in the PubMed database. ACL remnant preservation was the most extensively investigated technique. ACL reconstruction wi...
Article
Full-text available
Purpose: To present the arthroscopic “PCL envelope lack sign” (PELS) and to calculate its diagnostic characteristics in chronic PCL insufficiency. Methods: Recordings of knee arthroscopies performed in a single clinic between April 2015 to March 2020 were retrospectively evaluated, searching for the “PCL envelope”. It was defined as a “soft tissue...
Article
Purpose The purpose of the current study was to perform a systematic review and meta-analysis of the literature on anterolateral ligament (ALL) reconstruction as it related to techniques, biomechanical properties, and clinical outcomes. Methods PubMed, OVID/Medline, and Embase were queried in July 2020. Data pertaining to (1)techniques, (2)biomecha...
Article
Full-text available
Recurrent patellar dislocations have been correlated with an elevated risk of further patellar dislocations, often requiring surgical treatment. Risk factors include medial patellofemoral ligament (MPFL) tears, patella alta, trochlear dysplasia, and an increased tibial tubercle–trochlear groove distance. Surgical management must be based on a patie...
Article
Full-text available
A bipartite patella usually presents as an incidental finding on radiographs because most cases are asymptomatic. However, some patients may present with pain and functional limitations. Conservative treatment is sufficient to resolve symptoms in most cases; however, a small minority of patients may require surgical management. Recent studies have...
Article
Full-text available
Recurrent patellar dislocations are correlated with an elevated risk for further patellar dislocations. Chronic patellar instability is a disabling issue for some patients and may require surgical intervention for proper treatment. Risk factors for recurrent dislocations include medial patellofemoral ligament (MPFL) tears, patella alta, trochlear d...
Article
Full-text available
Injuries to the knee involving multiple ligaments occur in a variety of circumstances and require careful assessment and planning. A wide constellation of injuries can occur with causes sufficiently traumatic to produce bicruciate ligament deficiency, and this technical report will describe diagnosis, treatment and rehabilitation for a knee disloca...