ABSTRACT
Objectives To introduce arthroscopic posterior cruciate ligament (PCL) reconstruction with the tendon through the middle gap of remnant fiber and evaluate the recovery of postoperative knee function and the preliminary proprioception. Methods 17 cases of eligible patients of posterior cruciate ligament ruptures were performed arthro-scopic Single-beam type anatomical reconstruction with the tendon throung the middle gap of remnant fiber from August 2012 to March 2014. The tendon is fixed in operation through suspension of end-button and extrusion of bioabsorbable interference screw. The recovery of Knee function is assessed with comparative analyzing the preoper-ative and postoperative Lysholm and The International Knee Documentation Committee knee nation form (IKDC) subjective scores and KT-1000 (Joint stability measuring apparatus, PMENT NO 4.563 555, MEDmetric Corporation, San Diego, California, America) scores, and the postoperative proprioception of knee is assessed through measureing the time threshold to detection of passive motion(TTDPM) and the passive re-positioning (PRP) scores. Results There was no serious complications for all patients during the postoperative 12 month follow-up. Subjective scores showed:Lysholm scores from an average of (54.41 ±8.00) scores increased to (90.12±2.69) scores for 12 months followed up ( 0.05). Conclusion Arthroscopic posterior cruciate ligament reconstruction with tendon throughing remnant fiber can effectively restore the stability of the knee and improve knee function, preserving remnant stubs and syn-ovial of PCL may be beneficial recovery of proprioception and healing of reconstruction tendon.
ABSTRACT
Objective To investigate the efficacy and safety of the hemostatic techniques applied during the laparoscopic nephron-spring surgery in the treatment of renal tumor. Methods Twentytwo male and 8 female patients with renal tumors underwent laparoscopic nephron-sparing surgery by using the hemostatic techniques of harmonic scalpel, bipolar cautery and renal parenchyma defect suturing over surgical bolsters. Among them, 4 cases have been done transperitoneally and others have been done retroperitoneally. The mean patient age was 50 years. Of the 30 cases, 20 had renal cell cancers with a mean diameter of 2.5 cm, and 10 had renal angiomyolioma with a mean diameter of 2.4 cm. The operating time, estimated blood loss, length of postoperative hospital stay, complications and surgical results were recorded. Results All procedures were successfully completed. No case had converted to open surgery. The mean operating time was 169min and mean estimated blood loss was 100 ml. Major complications happened in 2 patients. One of them had accepted transfusion during surgery. Another case had retroperitoneal hemorrhage three days after surgery and had been treated with 800 ml blood transfusion. The mean post-operative hospital stay was 9 days. During the mean 9 month follow-up, no patient had local or trocar port site recurrence.Conclusion The hemostatic techniques of harmonic scalpel, bipolar cautery, renal parenchyma defect suturing over surgical bolsters could be effectively and safely applied in the laparoscopic nephron-sparing surgery.