Objective： To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament （ACL/PCL） reconstructions using Achilles tendon-bone allografts. Methods： Associated menis...Objective： To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament （ACL/PCL） reconstructions using Achilles tendon-bone allografts. Methods： Associated meniscus injuries were treated according to established methods prior to ligament reconstructions during arthroscopic surgery. Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results： Eleven men and 4 women with a minimum of 3-year follow-up （mean 38 months） were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelvebicruciate reconstructions were performed in subacute or chronic stage （〉3-8 weeks）, 3 for acute ligamentous deficiencies （≤ 3 weeks）. The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the difference was statistically significant （ttest, P〈0.001） before and after operation. Conclusions： Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.展开更多
Objective： To introduce a novel technique in which meniscal stitching needle is used as a puller to induct steel wire to secure the tibial eminence avulsion under arthroscopic visualization, and evaluate the cfinical...Objective： To introduce a novel technique in which meniscal stitching needle is used as a puller to induct steel wire to secure the tibial eminence avulsion under arthroscopic visualization, and evaluate the cfinical results. Methods： From 1999 to 2005, fifteen cases of tibial eminence avulsion were treated with this new technique. Lysholm scoring scale system was used to assess knee function before and after surgery. Regular plain anteroposterior and lateral X-ray flms were undertaken to detect the bony healing of avulsed fragment. Results： The operating time could be controlled within 30 minutes. No complications such as intraarticular infection, iatrogenic injury, fibroarthritis or nonunion of fracture occurred in this group. X-ray film revealed that bony healing in all 15 cases was achieved from 6 weeks to 12 weeks postoperatively. Lysholm score was improved from 19.1 ± 15.2 （ ranging from 10 to 56 ） preoperatively to 97.5 ± 3.7 （ranging from 91 to 100） postoperatively on average in 12-54 months follow up （mean 23 months）. The statistically significant difference was shown in Student＇s t test （t = 18. 483, P =3. 100×10^-11, P 〈 0. 01）. Wire breakage was found in two patients whose wires were removed 8 months and 14 months after initial operation, respectively. Conclusion： This technique has many advantages, such as simplicity, wide indications from type Ⅱ to type Ⅳ fractures, minimal invasion, short operating time and predictable satisfactory results.展开更多
To evaluate operative effects of a new method to reconstruct anterior crucial ligament （ ACL ） and posterior crucial ligament （PCL） simultaneously by using patellar tendon under arthroscopy. Methods： From Novemb...To evaluate operative effects of a new method to reconstruct anterior crucial ligament （ ACL ） and posterior crucial ligament （PCL） simultaneously by using patellar tendon under arthroscopy. Methods： From November 1999 to November 2003, the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and γ radiation. At the same time, 2 patients were treated with medial collateral ligament （MCL） reconstruction, 3 with lateral collateral ligament （LCL） reconstruction. 1 with meniscus suture and 4 with whole or partial resection. Results： All patients were followed up for 12-26 months （average 16.5 months ）. The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test （ADT） was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2 postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°. Conclusions： As for simultaneous reconstruction of ACL and PCL under arthroscopy, allogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.展开更多
文摘Objective： To evaluate the clinical outcome of arthroscopically assisted combined anterior and posterior cruciate ligament （ACL/PCL） reconstructions using Achilles tendon-bone allografts. Methods： Associated meniscus injuries were treated according to established methods prior to ligament reconstructions during arthroscopic surgery. Thirty Achilles tendon-bone allografts were used to reconstruct torn ACL and PCL in 15 knees. At postoperative follow-up, all knees were graded using the modified IKDC and the Lysholm scoring systems just as done preoperatively. Results were analyzed compared with the contralateral healthy knees. Results： Eleven men and 4 women with a minimum of 3-year follow-up （mean 38 months） were included in the study. Preoperatively, the group ratings by the modified IKDC standards were all severely abnormal. Twelvebicruciate reconstructions were performed in subacute or chronic stage （〉3-8 weeks）, 3 for acute ligamentous deficiencies （≤ 3 weeks）. The noticeable early complication was transitory local fever combined with joint effusion in one case. At postoperative follow-up, 9 knees were normal, 5 nearly normal and 1 abnormal. On Lysholm score the difference was statistically significant （ttest, P〈0.001） before and after operation. Conclusions： Achilles tendon-bone allograft offers an alternative for simultaneous arthroscopic ACL/PCL reconstructions. However, further investigation is needed to eradicate its potential immunogenicity for better use.
文摘Objective： To introduce a novel technique in which meniscal stitching needle is used as a puller to induct steel wire to secure the tibial eminence avulsion under arthroscopic visualization, and evaluate the cfinical results. Methods： From 1999 to 2005, fifteen cases of tibial eminence avulsion were treated with this new technique. Lysholm scoring scale system was used to assess knee function before and after surgery. Regular plain anteroposterior and lateral X-ray flms were undertaken to detect the bony healing of avulsed fragment. Results： The operating time could be controlled within 30 minutes. No complications such as intraarticular infection, iatrogenic injury, fibroarthritis or nonunion of fracture occurred in this group. X-ray film revealed that bony healing in all 15 cases was achieved from 6 weeks to 12 weeks postoperatively. Lysholm score was improved from 19.1 ± 15.2 （ ranging from 10 to 56 ） preoperatively to 97.5 ± 3.7 （ranging from 91 to 100） postoperatively on average in 12-54 months follow up （mean 23 months）. The statistically significant difference was shown in Student＇s t test （t = 18. 483, P =3. 100×10^-11, P 〈 0. 01）. Wire breakage was found in two patients whose wires were removed 8 months and 14 months after initial operation, respectively. Conclusion： This technique has many advantages, such as simplicity, wide indications from type Ⅱ to type Ⅳ fractures, minimal invasion, short operating time and predictable satisfactory results.
文摘To evaluate operative effects of a new method to reconstruct anterior crucial ligament （ ACL ） and posterior crucial ligament （PCL） simultaneously by using patellar tendon under arthroscopy. Methods： From November 1999 to November 2003, the injured ACL and PCL of 11 patients were fixated with compressed screws and reconstructed under arthroscopy with the bone-patellar tendon-bone treated with deep hypothermia and γ radiation. At the same time, 2 patients were treated with medial collateral ligament （MCL） reconstruction, 3 with lateral collateral ligament （LCL） reconstruction. 1 with meniscus suture and 4 with whole or partial resection. Results： All patients were followed up for 12-26 months （average 16.5 months ）. The Lysholm score method was employed to evaluate the knee function. The average preoperative score was 45.3 and the postoperative score was 86.4. Anterior drawer test （ADT） was positive in 11 knees preoperatively and feeble positive in one knee postoperatively. Lachman test was positive in 11 knees preoperatively and in one postoperatively, and feebly positive in two postoperatively. Posterior drawer test was positive in 11 knees preoperatively and feebly positive in 2 postoperatively. There were 2 knees with tolerable pain and 2 with knee flexion of 5°-20°. Conclusions： As for simultaneous reconstruction of ACL and PCL under arthroscopy, allogeneic bone-patellar tendon-bone can not only avoid injury and complication caused by autografting, but also help rehabilitation of the knee function.
