Background It has been demonstrated that bone tunnel widening could appear after knee anterior cruciate ligament (ACL) reconstruction, especially for those patients whose ruptured ACL were reconstructed with semitendi...Background It has been demonstrated that bone tunnel widening could appear after knee anterior cruciate ligament (ACL) reconstruction, especially for those patients whose ruptured ACL were reconstructed with semitendinosus and gracilis tendons. Many factors can influence the extent of tunnel widening. Few studies have investigated the relationship between bone tunnel widening and rehabilitation procedures. This research was carried out to find the rehabilitation procedures' influence on the tibial bone tunnel widening after ACL reconstruction. Methods Sixty-five cases, whose ACL reconstructions were done using quadrupled semitendinosus and gracilis tendons, were divided into two groups. Group A had 33 cases, 19 men, 14 women, averaged (31.2±12.4) years old, only ACL reconstruction was done using Paessler's technique, and aggressive rehabilitation procedure was used for function recovery post operation. Group B had 32 cases, 20 men, 12 women, averaged (30.3±10.3) years old. Except for ACL reconstruction, every patient in group B accepted meniscus repair using re-fixation methods or cartilage repair using microfracture technique, conservative rehabilitation procedure was used post operation. Six months post operation, standard posterior-anterior radiographic plates were taken for each case, CorelDRAW 8.0 software was used to digitize all X-ray plates and measure the upper, middle and lower parts of the tibial tunnel. Magnification effect of X-ray plates was taken out after measurement. Results Six months after ACL reconstruction the tibial tunnel widening of the upper, middle and lower parts on both the posterior-anterior and lateral X-ray plates in Group A with aggressive rehabilitation procedure was much more serious than in Group B with conservative rehabilitation. KT-1000 knee stability measurement and clinical manifestation showed no difference between the two groups. Conclusions Rehabilitation procedure after ACL reconstruction is one of the reasons for tunnel widening. It not only can directly influence the function recovery of ACL reconstructed knee, but also perhaps indirectly influence the function recovery and long-term clinical result of the operated knee by influencing the tunnel widening.展开更多
Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconst...Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction. The aim of this study was to evaluate the clinical results of four-tunnel DB ACL reconstruction.Methods Sixty-four consecutive patients with ACL ruptures from May 2005 to May 2006 were randomly assigned into two groups: 32 cases for SB ACL reconstruction and 32 cases for DB ACL reconstruction. Clinical data, including KT 2000, Biodex test, Lysholm score, Tegner score and IKDC score, were prospectively collected until at least 10 months post-operative.Results The average values of KT 2000 were (1.47±1.17) mm and (1.68±1.14) mm for the SB and DB ACL reconstruction groups at 30° of knee flexion (P 〉0.05), and were (1.04±0.98) mm and (1.13±0.98) mm at 90° of knee flexion (P 〉0.05). There were also no significant differences in Lysholm score, Tegner score, IKDC score and Biodex test scores between the two groups (P 〉0.05). The operation time of DB ACL reconstruction was 20 minutes longer than the SB ACL reconstruction (P 〈0.05)Conclusion Double bundle ACL reconstructions have no obvious clinical advantages over single bundle ACL reconstructions.展开更多
Background Medial patellofemoral ligament (MPFL) reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patell...Background Medial patellofemoral ligament (MPFL) reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patellar side fixation in medial patellofemoral ligament reconstruction for recurrent patellar dislocation, and to evaluate the intermediate-term results. Methods We retrospectively reviewed the results of 22 MPFL reconstructions in 21 patients (6 male and 15 female) with a suture-tie technique performed by a single surgeon between March 2004 and July 2009. All patients had been diagnosed with recurrent patellar dislocation. Outcomes were assessed preoperatively and postoperatively by physical and radiographic examination as well as with Kujala and Lysholm scores. Results At the mean follow-up month 37.5 (range: 24-56 months), there was no graft failure. Primary healing was achieved in all cases. At the final follow-up, the mean Kujala score improved from 53.9 (range: 46-62 points) to 84.1 (range: 78-90 points) postoperatively (P 〈0.05), and the mean Lysholm score improved from 47.2 points (range: 37-57 points) to 82.8 points (range: 76-89 points) postoperatively (P 〈0.05). To date, no patients have reported redislocation or subluxation; however, there is one patient with a positive apprehension test. Conclusion A suture-tie technique in medial patellofemoral ligament reconstruction can restore patella stability without significant complication.展开更多
文摘Background It has been demonstrated that bone tunnel widening could appear after knee anterior cruciate ligament (ACL) reconstruction, especially for those patients whose ruptured ACL were reconstructed with semitendinosus and gracilis tendons. Many factors can influence the extent of tunnel widening. Few studies have investigated the relationship between bone tunnel widening and rehabilitation procedures. This research was carried out to find the rehabilitation procedures' influence on the tibial bone tunnel widening after ACL reconstruction. Methods Sixty-five cases, whose ACL reconstructions were done using quadrupled semitendinosus and gracilis tendons, were divided into two groups. Group A had 33 cases, 19 men, 14 women, averaged (31.2±12.4) years old, only ACL reconstruction was done using Paessler's technique, and aggressive rehabilitation procedure was used for function recovery post operation. Group B had 32 cases, 20 men, 12 women, averaged (30.3±10.3) years old. Except for ACL reconstruction, every patient in group B accepted meniscus repair using re-fixation methods or cartilage repair using microfracture technique, conservative rehabilitation procedure was used post operation. Six months post operation, standard posterior-anterior radiographic plates were taken for each case, CorelDRAW 8.0 software was used to digitize all X-ray plates and measure the upper, middle and lower parts of the tibial tunnel. Magnification effect of X-ray plates was taken out after measurement. Results Six months after ACL reconstruction the tibial tunnel widening of the upper, middle and lower parts on both the posterior-anterior and lateral X-ray plates in Group A with aggressive rehabilitation procedure was much more serious than in Group B with conservative rehabilitation. KT-1000 knee stability measurement and clinical manifestation showed no difference between the two groups. Conclusions Rehabilitation procedure after ACL reconstruction is one of the reasons for tunnel widening. It not only can directly influence the function recovery of ACL reconstructed knee, but also perhaps indirectly influence the function recovery and long-term clinical result of the operated knee by influencing the tunnel widening.
文摘Background In clinical studies there is still a lot of controversy about the increased anterior and rotational stability between double-bundle (DB) and single-bundle (SB) anterior cruciate ligament (ACL) reconstruction. The aim of this study was to evaluate the clinical results of four-tunnel DB ACL reconstruction.Methods Sixty-four consecutive patients with ACL ruptures from May 2005 to May 2006 were randomly assigned into two groups: 32 cases for SB ACL reconstruction and 32 cases for DB ACL reconstruction. Clinical data, including KT 2000, Biodex test, Lysholm score, Tegner score and IKDC score, were prospectively collected until at least 10 months post-operative.Results The average values of KT 2000 were (1.47±1.17) mm and (1.68±1.14) mm for the SB and DB ACL reconstruction groups at 30° of knee flexion (P 〉0.05), and were (1.04±0.98) mm and (1.13±0.98) mm at 90° of knee flexion (P 〉0.05). There were also no significant differences in Lysholm score, Tegner score, IKDC score and Biodex test scores between the two groups (P 〉0.05). The operation time of DB ACL reconstruction was 20 minutes longer than the SB ACL reconstruction (P 〈0.05)Conclusion Double bundle ACL reconstructions have no obvious clinical advantages over single bundle ACL reconstructions.
文摘Background Medial patellofemoral ligament (MPFL) reconstruction is the preferred operative treatment for recurrent patellar dislocation. The purpose of this study was to report a novel suture-tie technique of patellar side fixation in medial patellofemoral ligament reconstruction for recurrent patellar dislocation, and to evaluate the intermediate-term results. Methods We retrospectively reviewed the results of 22 MPFL reconstructions in 21 patients (6 male and 15 female) with a suture-tie technique performed by a single surgeon between March 2004 and July 2009. All patients had been diagnosed with recurrent patellar dislocation. Outcomes were assessed preoperatively and postoperatively by physical and radiographic examination as well as with Kujala and Lysholm scores. Results At the mean follow-up month 37.5 (range: 24-56 months), there was no graft failure. Primary healing was achieved in all cases. At the final follow-up, the mean Kujala score improved from 53.9 (range: 46-62 points) to 84.1 (range: 78-90 points) postoperatively (P 〈0.05), and the mean Lysholm score improved from 47.2 points (range: 37-57 points) to 82.8 points (range: 76-89 points) postoperatively (P 〈0.05). To date, no patients have reported redislocation or subluxation; however, there is one patient with a positive apprehension test. Conclusion A suture-tie technique in medial patellofemoral ligament reconstruction can restore patella stability without significant complication.