BACKGROUND Recently,the use of ligament advanced reinforcement system(LARS)artificial ligament,a new graft which has several unique advantages such as no donor-site morbidity,early recovery and no risk of disease tran...BACKGROUND Recently,the use of ligament advanced reinforcement system(LARS)artificial ligament,a new graft which has several unique advantages such as no donor-site morbidity,early recovery and no risk of disease transmission which has been a significant breakthrough for anatomical ligament reconstruction.Growing studies suggested that the special design of the LARS ligament with open fibers in its intra-articular part was believed to be more resistant to torsional fatigue and wearing.However,the safety and efficacy of LARS artificial ligament for ankle joint lateral collateral ankle ligament reconstruction has not been defined to date.AIM To evaluate the clinical results of all-arthroscopic anatomical reconstruction of ankle joint lateral collateral ligaments with the LARS artificial ligament for chronic ankle instability.METHODS Twenty-two patients with chronic lateral instability underwent anatomical reconstruction of the lateral collateral ligaments of ankle with LARS artificial ligament.The visual analogue score(VAS),American Orthopaedic Foot and Ankle Society score(AOFAS score)and Karlsson score were used to evaluate the clinical results before and after surgery.RESULTS A total of 22 patients(22 ankles)were followed up for a mean of 12 mo.All patients reported significant improvement compared to their preoperative status.The mean AOFAS score improved from 42.3±4.9 preoperatively to 90.4±6.7 postoperatively.The mean Karlsson score improved from 38.5±3.2 preoperatively to 90.1±7.8 postoperatively.The mean VAS score improved from 1.9±2.5 preoperatively to 0.8±1.7 postoperatively.CONCLUSION All-arthroscopic anatomical reconstruction of the lateral collateral ligaments with LARS artificial ligament achieved a satisfactory surgical outcome for chronic ankle instability.展开更多
In the published literature as well as in the most commonly used textbooks, the lateral collateral ligament (LCL) is described as having 1 attachment at the lateral epicondyle of the femur and another at the head of t...In the published literature as well as in the most commonly used textbooks, the lateral collateral ligament (LCL) is described as having 1 attachment at the lateral epicondyle of the femur and another at the head of the fibula. In this article, we reconsider the attachments, the length of the LCL, and the tissues surrounding the LCL by presenting our anatomical observations and by reviewing the literature. Our results have shown that the LCL is not only attached to the lower part of the lateral epicondyle of the femur, but also extends to the upper part of the lateral epicondyle. The attachment of the LCL on the fibula is enclosed by 2 insertion points of the biceps femoris tendon. The average length of the LCL in 71 knees was 51.4 mm. There is an “incomplete gap” on the LCL that is interrupted under the tendon of the biceps femoris.展开更多
Objective To compare the efficacy of Tuina(Chinese therapeutic massage)plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts,and to explore the feasibility of Tuina...Objective To compare the efficacy of Tuina(Chinese therapeutic massage)plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts,and to explore the feasibility of Tuina for injury intervention in competitive athletes.Methods A total of 64 gymnasts with types Ⅰ-Ⅱ lateral collateral ligament injury of ankle were selected and divided into a control group and an observation group according to a full analysis set based on the intention-to-treat principle,with 32 cases in each group.Patients in the control group received ultrasound and microwave treatment,while those in the observation group received additional Tuina manipulations.The efficacy was evaluated by total effective rate,visual analog scale(VAS)score,and American Orthopedic Foot and Ankle Society ankle-hindfoot scale(AOFAS-AHS)score.Results The total effective rate was 96.9% in the observation group and 90.6% in the control group.There was no statistical difference in the total effective rate between the two groups(P>0.05).The markedly effective rate was 75.0% in the observation group and 46.9% in the control group.The markedly effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the VAS scores of both groups showed a downward trend,and there were statistical differences between different treatment time points in the same group(P<0.05).After one and three months of treatment,the VAS scores of the observation group were lower than those of the control group(P<0.05).There were statistical differences in the AOFAS-AHS score before and after treatment within the same group(P<0.05).After one month of treatment,there was no statistical difference in the AOFAS-AHS score between the two groups(P>0.05).After three months of treatment,the AOFAS-AHS score in the observation group was higher than that in the control group,indicating statistical significance(P<0.05).There was an interaction between time and group(P<0.05).Conclusion Tuina plus physical agents can improve the symptoms of lateral collateral ligament injury of ankle in gymnasts.This combined treatment is superior to physical agents alone in relieving pain and improving joint functions.Therefore,Tuina plus physical agents can be used as a treatment for lateral collateral ligament injury of ankle in gymnasts.展开更多
BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED ma...BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed reduction.CASE SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow extended.She developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th digits.Radiologic investigation confirmed the SLED,and a closed reduction under anesthesia was performed.The follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried out.The patient regained full elbow range of motion by six weeks.CONCLUSION Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.展开更多
文摘BACKGROUND Recently,the use of ligament advanced reinforcement system(LARS)artificial ligament,a new graft which has several unique advantages such as no donor-site morbidity,early recovery and no risk of disease transmission which has been a significant breakthrough for anatomical ligament reconstruction.Growing studies suggested that the special design of the LARS ligament with open fibers in its intra-articular part was believed to be more resistant to torsional fatigue and wearing.However,the safety and efficacy of LARS artificial ligament for ankle joint lateral collateral ankle ligament reconstruction has not been defined to date.AIM To evaluate the clinical results of all-arthroscopic anatomical reconstruction of ankle joint lateral collateral ligaments with the LARS artificial ligament for chronic ankle instability.METHODS Twenty-two patients with chronic lateral instability underwent anatomical reconstruction of the lateral collateral ligaments of ankle with LARS artificial ligament.The visual analogue score(VAS),American Orthopaedic Foot and Ankle Society score(AOFAS score)and Karlsson score were used to evaluate the clinical results before and after surgery.RESULTS A total of 22 patients(22 ankles)were followed up for a mean of 12 mo.All patients reported significant improvement compared to their preoperative status.The mean AOFAS score improved from 42.3±4.9 preoperatively to 90.4±6.7 postoperatively.The mean Karlsson score improved from 38.5±3.2 preoperatively to 90.1±7.8 postoperatively.The mean VAS score improved from 1.9±2.5 preoperatively to 0.8±1.7 postoperatively.CONCLUSION All-arthroscopic anatomical reconstruction of the lateral collateral ligaments with LARS artificial ligament achieved a satisfactory surgical outcome for chronic ankle instability.
文摘In the published literature as well as in the most commonly used textbooks, the lateral collateral ligament (LCL) is described as having 1 attachment at the lateral epicondyle of the femur and another at the head of the fibula. In this article, we reconsider the attachments, the length of the LCL, and the tissues surrounding the LCL by presenting our anatomical observations and by reviewing the literature. Our results have shown that the LCL is not only attached to the lower part of the lateral epicondyle of the femur, but also extends to the upper part of the lateral epicondyle. The attachment of the LCL on the fibula is enclosed by 2 insertion points of the biceps femoris tendon. The average length of the LCL in 71 knees was 51.4 mm. There is an “incomplete gap” on the LCL that is interrupted under the tendon of the biceps femoris.
文摘Objective To compare the efficacy of Tuina(Chinese therapeutic massage)plus physical agents and physical agents alone for lateral collateral ligament injury of ankle in gymnasts,and to explore the feasibility of Tuina for injury intervention in competitive athletes.Methods A total of 64 gymnasts with types Ⅰ-Ⅱ lateral collateral ligament injury of ankle were selected and divided into a control group and an observation group according to a full analysis set based on the intention-to-treat principle,with 32 cases in each group.Patients in the control group received ultrasound and microwave treatment,while those in the observation group received additional Tuina manipulations.The efficacy was evaluated by total effective rate,visual analog scale(VAS)score,and American Orthopedic Foot and Ankle Society ankle-hindfoot scale(AOFAS-AHS)score.Results The total effective rate was 96.9% in the observation group and 90.6% in the control group.There was no statistical difference in the total effective rate between the two groups(P>0.05).The markedly effective rate was 75.0% in the observation group and 46.9% in the control group.The markedly effective rate in the observation group was higher than that in the control group(P<0.05).After treatment,the VAS scores of both groups showed a downward trend,and there were statistical differences between different treatment time points in the same group(P<0.05).After one and three months of treatment,the VAS scores of the observation group were lower than those of the control group(P<0.05).There were statistical differences in the AOFAS-AHS score before and after treatment within the same group(P<0.05).After one month of treatment,there was no statistical difference in the AOFAS-AHS score between the two groups(P>0.05).After three months of treatment,the AOFAS-AHS score in the observation group was higher than that in the control group,indicating statistical significance(P<0.05).There was an interaction between time and group(P<0.05).Conclusion Tuina plus physical agents can improve the symptoms of lateral collateral ligament injury of ankle in gymnasts.This combined treatment is superior to physical agents alone in relieving pain and improving joint functions.Therefore,Tuina plus physical agents can be used as a treatment for lateral collateral ligament injury of ankle in gymnasts.
文摘BACKGROUND Simple lateral elbow dislocation(SLED)is a rare type of elbow dislocation;however,its treatment may be complicated by accompanying soft tissue or neurovascular damage.Herein,we report a rare case of SLED managed secondarily with open reduction and soft tissue repair following failure of closed reduction.CASE SUMMARY A 67-year-old woman suffered SLED after falling on her outstretched left hand with her elbow extended.She developed pain,swelling,and movement restriction in the elbow;there were no neurovascular symptoms,except for numbness in the 4th and 5th digits.Radiologic investigation confirmed the SLED,and a closed reduction under anesthesia was performed.The follow-up radiographs at 1-wk revealed failure of reduction;accordingly,open reduction with lateral collateral ligament and common extensor origin repair were carried out.The patient regained full elbow range of motion by six weeks.CONCLUSION Adequate concentric reduction for SLED,conservatively or surgically,reduces complications and provides a more functional joint.
