Arthroscopic Removal of Metallic Suture Anchors Placed after Bankart Repair

Purpose: The aim of this study was to present our surgical outcomes in patients who underwent arthroscopic removal of poorly positioned and/or proud metallic suture anchors applied during or after Bankart repair. Methods: A total of 14 patients who underwent open or arthroscopic Bankart repair with an initial presentation of traumatic shoulder instability between January 2010 and January 2017 and admitted to our center with complaints due to poorly positioned and/or proud metallic suture anchors were enrolled. Pre- and intraoperative findings, surgical outcomes and complications were reviewed. Diagnosis of proud or poorly positioned suture anchors was established using magnetic resonance imaging (MRI) of shoulder in five cases, and with shoulder arthroscopy in nine patients. Outcomes were measured by the use of the CONSTANT score and American Shoulder and Elbow Society (ASES) score. Results: Eleven male and three female patients with an average age of 29.21 ± 5.78 (range, 20 to 42) were enrolled in the present study. Revision Bankart repair was performed arthroscopically in all patients. The mean follow-up period was 40.4 months, ranging from 18 to 64 months. The preoperative Constant and ASES scores were 68.43 ± 7.05 and 38.3 ± 19.4, respectively. Postoperatively, the scores were 89.64 ± 5.39 and 89.07 ± 3.89, respectively (p Conclusion: To conclude, arthroscopy may yield an effective surgical option for removal of poorly positioned and/or proud metallic suture anchors after Bankart repair. However, further clinical reports on larger series are warranted to document the efficacy of this procedure in selected cases.

Preliminary Results of Double-Bundle Anterior Cruciate Ligament Reconstruction and Technique-Specific Problems

Background: In this study, we determined the efficiency of anterior cruciate ligament (ACL) reconstruction using the double-bundle technique and addressed technique-specific problems. Patients and Methods: Twenty-nine patients who underwent ACL reconstruction due to ACL rupture with the arthroscopic double-bundle ENDOBUTTON CL method using autogenous hamstring tendons were evaluated. All patients were males and the mean age was 24.3 years (range 20 - 41 years). The mean follow-up period was 36.4 months (minimum 16 and maximum 53 months). Diagnosis was based on medical history and physical examination. Lachman, anterior drawer and pivot shift tests were performed. The patient diagnosis was verified with X-ray roentgenogram and magnetic resonance imaging (MRI). Tunnel mergence and graft hanging problems were discussed. Results: Pre- and postoperative clinical assessments of the patients showed the mean Lysholm score increased from 60.2 (48 - 72) preoperatively to 91.5 (85 - 98) at the final visit, whereas the mean Tegner score increased from 5.58 (3 - 9) preoperatively to 6.03 (4 - 9) at the final visit. According to the International Knee Documentation Committee (IKDC) knee ligament standard evaluation system, five patients were classified as B (17%);11 patients were classified as C (38%);and 13 patients were classified as D (45%) before the surgery. At the postoperative evaluation, 17 (59%) patients were classified as A;11 (38%) patients were classified as B;and 1 (3%) patient was classified as C. Conclusion: The double-bundle technique using hamstring tendons and femoral braces is an efficient and satisfactory method for ACL reconstruction.

Relationship between Coronal Alignment and Posterior Tibial Slope in the Lower Extremity

Purpose: To restore the normal axial alignment of the lower extremity is important in reconstructive knee surgery. The aim of this study was to evaluate lower-limb alignment and posterior tibial slope. Methods: Thirty-two male and 32 female outpatients aged 22 to 46 were recruited. A full weight-bearing anteroposterior radiograph of the entire lower limb was obtained for each subject. The axial alignment was measured based on the centers of the femoral head, knee, and ankle. The tibiofemoral (TF), tibial joint (TJ), and posterior tibial slope (TS) angles were determined. Results: The mean TF angle was more varus in women (177.8°) than men (179.2°), and the mean TJ angle was more medially inclined in women than men. Women had a greater TJ angle than men (93.3° vs. 91.6°). The mean posterior TS was greater in men than women (16.0° vs. 12.5°, p < 0.05), while the mean TS angle was greater in women (14.8°) than men (12.3°). Conclusion: Knee alignment and geometry vary among populations. In our study, the TF angle was varus among all participants. The knee joint was more medially inclined in women than men. And also the posterior TS was greater in women than men.