ABSTRACT
BACKGROUND:Autologous peroneus brevis and alogeneic tendon are often used for reconstruction of lateral colateral ligament of the ankle joint, but these two kinds of materials have different histological and biomechanical properties. OBJECTIVE:To compare the clinical effects of autologous peroneus brevis and alogeneic tendon to reconstruct lateral colateral ligament of the ankle joint. METHODS: Sixty-six patients with chronic external ankle instability caused by old injury to lateral colateral ligament of the ankle joint were enroled, aged 15-63 years. The 34 of 66 patients underwent lateral ligament reconstruction using autologous peroneus brevis and the rest 32 patients received lateral ligament reconstruction using alogeneic tendon. After reconstruction, reaction time of the peroneous brevis, talar tilt angle and anterior talar translation, visual analog scale score and the American Orthopaedic Foot and Ankle Society (AOFAS) score were compared between the two groups. RESULTS AND CONCLUSION:At the last folow-up, the visual analog scale score, tilt angle and anterior talar translation were lowered in the two groups compared with the previous (P < 0.05), and the AOFAS scores were increased significantly in the two groups (P < 0.05); the reaction time of the peroneous brevis was increased inthe autologous peroneus brevis group (P < 0.05) and decreased in the alogeneic tendon group (P < 0.05); the above-mentioned indexes had no difference between the two groups. These findings indicate that autologous peroneus brevis and alogeneic tendon have similar effects on the lateral ligament reconstruction in terms of postoperative ankle function, stability and activity levels, but the alogeneic tendon shows advantages on less trauma and shorter operation time.
ABSTRACT
BACKGROUND:MRI characterized as non-invasion, high resolution, high sensitivity and specificity to injury has become another important means for diagnosis of knee joint disease folowing the arthroscopy. OBJECTIVE: To explore the effective evaluation on the knee meniscus injury diagnosis, by comparing the results of MRI and arthroscopy of the knee meniscus. METHODS: Clinical data of 206 patients with meniscus injury were retrospectively analyzed. Every case was subjected to MRI and the arthroscopy. The findings of arthroscopy were considered as the golden standard. Then, the sensitivity, specificity and coincidence rate of MRI in the diagnosis of meniscus injury were calculated. The chi-square analysis was used to evaluate the MRI and arthroscopy in the diagnosis of meniscus injury. The Kappa values were used to test the consistency of MRI with arthroscopy in the diagnosis of meniscus injury. RESULTS AND CONCLUSION:For levels 0 and I meniscus injury, the coincidence rate of MRI was 97%; for level II meniscus injury, the coincidence rate of MRI was 91.1%, and there was no significant difference (P > 0.05). For level III meniscus injury, the sensitivity, specificity, concordance rate and Youden index of MRI were 92.9%, 94.4%, 93.7% and 87.3%, respectively. By the consistency checking, the value of Kappa was 0.874 and χ2 so there was a high consistency checking between the data of MRI and arthroscopy (P=0.000). MRI is a noninvasive diagnostic method for meniscus injury. For patients with levels I and II meniscus injury on MRI, arthroscopy should be cautiously adopted; however, for patients with level III meniscus injury on MRI, arthroscopy should be done as early as possible. Arthroscopic observation is more intuitive that enables to make accurate judgments of meniscus injury to reduce the rate of misdiagnosis.