ABSTRACT
BACKGROUND: The purpose of this study was to evaluate factors associated with the risk of articular surface perforation during anchor placement for arthroscopic acetabular labral repair using follow-up computed tomographic arthrography (CTA). METHODS: Forty-six patients (29 males and 17 females) underwent arthroscopic labral repair using 142 suture anchors (55 large anchors and 87 small anchors). The patients were followed with CTA 1 year postoperatively. Anchor position was assessed by the insertion angle and the distance of the suture anchor tip from the articular cartilage. The incidence of malposition of suture anchors was assessed in follow-up CTA. The location and incidence of malposition were compared between two groups divided according to the diameter of suture anchor. RESULTS: The mean insertion angle and distance were significantly different between the groups. Of the 142 anchors, 15 (11%) were placed in the cartilage-bone transitional zone. Articular involvement was most common at the 3 o'clock position of the suture anchor (six out of 33 anchors, 18.2%). Both the insertion angle and distance showed small values in the articular involvement group. CONCLUSIONS: The radiographic analysis of the placement of suture anchors after arthroscopic labral refixation based on follow-up CTA demonstrates that articular involvement of anchors is related to the location on the acetabular rim (clock position) and anchor diameter.
Subject(s)
Humans , Male , Acetabulum , Arthrography , Cartilage, Articular , Follow-Up Studies , Incidence , Risk Factors , Suture AnchorsABSTRACT
PURPOSE; To evaluate the effects of the chitosan-TGF-beta(1) conjugate and TGF-beta(1) on osteoarthritic rabbit cartilage induced by collagenase type II. MATERIALS AND METHODS; Chemical arthritis was induced in right knee of 15 rabbits by injection of collagenase type II (4 mg/mL, 0.25 cc) twice at day 1 and 4, and then each 5 rabbits were treated by intra-articular injection of TGF-beta(1) (15 ng/mL, 1 mL, group I), chitosan-TGF-beta(1) conjugate (Chitosan: 5.8 g/mL, TGF-beta(1): 15 ng/mL, group II) and PBS (1 mL, group III) at 10 days later in the same knees. The appearance of the injected knee joints and lameness were observed weekly. The articular cartilage and synovium obtained at 4 weeks were analysed by gross findings (India ink), histological examinations (H&E, Safrainin O) and evaluation through the Kikuchi score. RESULT; The osteoarthritic sign about knee joints was the most severe at 1 weeks after the initiation of collagenase injections, but there wasere no difference of 3 groups in osteoarthritic sign and lameness was most severe in group 3. Group 2 showed the most superior results in gross findings using india ink and the these results were more prominent in the evaluation of histological scoring (average scores of each group I:14+/-2.7, II:10.3+/-1.2, III:20.3+/-3.7). CONCLUSION; These results might suggest that, in the rabbit osteoarthritic knee model induced by collagenase, Chitosan-TGF-beta(1) conjugate is more effective than only TGF-beta(1) in inhibiting cartilage degeneration.
Subject(s)
Rabbits , Arthritis , Cartilage , Cartilage, Articular , Collagenases , India , Injections, Intra-Articular , Ink , Knee Joint , Knee , Osteoarthritis , Synovial MembraneABSTRACT
The arthroscopic procedure has been one of the useful treatment modalitis in osteoarthritis of the knee, which does not respond to conservative treatment. Authors reviewed the resuJts of 61cases of 61 patients(18 males and 43 females) that had been treated with arthroscopic procedures including arthroscopic simple )avage, partial menisectomy, removal of the loose bodies, synovectomy and chondroplasty. The purpose of this study is to evaluate indication and effectiveness of arthroscopic surgery for osteoarthritic knee. 1. Seventy-one percent of sixty-one patients had relief of pain and other clinical symptoms after arthroscopic procedures. 2. Sixty-one pereent were still good at last follow-up more, than one year. 3. The favorable results were obtained after removal of loose bodies or partial menisectomy in association with osteoarthritic knee cornpared with the other procedures. And the poor results were obtained in patients with severe degenerative changes and severe cartilage defects of both femoral condyles. 4. The normal-alignment knees had much better results after arthroscopic surgery compared with valgus or varus knees. Our results suggest that arthroscopic surgery can be one of the good alternative treatment methods for osteoarthritic knee and a time-saving procedure before arthroplastic surgery.
Subject(s)
Humans , Male , Arthroscopy , Cartilage , Follow-Up Studies , Knee , OsteoarthritisABSTRACT
Authors analyzed the findings of nineteen cases of arthroscopic second-look operations after posterior cruciate ligament (PCL) reconstruction with autogenous bone-patellar tendon-bone (BPTB) and Trevira augmentation by two tunnel technique during the period from Nov, 1993 to Jan. l997 in fifty-one cases, along with the results of reconstruction in terms of clinica1 knee scoring, radiographichl and arthroscopic findings. The results were as follows; Age ranged fmm 20 to 53 years, the average being 32.3 years. Thirteen cases (68%) had associated knee injuries; five medial collateral ligament (MCL) injuries, four lateral collateral ligament (LCL) injuries, two associated injuries of MCL and medial meniscus, one both menisci and one associated injury of anterior cruciate ligament and MCL. The average period fmm PCL injury to reconstruction was 7 weeks (range, 1 to 52 wecks) and the mean period from PCL reconstruction to second-look operation was 20.3 months (range, 10 to 46 months). The average Miiller s knee score at the last follow-up was 86 paints. The radiographical results: The distance of posterior translation of the PCL reconstrueted knee compared with the normal sidc knee in posterior stress roentgenography was average 3.8mm (range, 0 to 1 1 mm). The position of the fernoral bone block on the plane of extended Blumansaats line, from the anterior end of the line, was average 32%. The level of proximal end of the tibial bone block according to the tibial tunnel orifice into the joint was mean negative 2.6 degrees position. The findings of arthroscopic second-look examination; In 9 cases (47%), the reconstructed ligamcnts were well covered with synovial tissue and looked like almost normal PCL. There were five cases (26%) of severe fragmentation, three cases (16%) of partial torn fibers of the grafted tendon. And one case showed the thinning of thc grafted tendon compared with the initial diameter at the time of reconstruction and one case showed overgrawth of the synovial membrane which suitounding the grafted tendon. All the Trevira which were augmented at the time of PCL reconstruction were ruptured. Twelve cases (63%) were stable, three cases (16%) were slightly lax and 4 cases (21%) showed laxity of the grafted tendon by the posterior drawer test and probing under arthroscopy, The isometricity which was checked at the time of PCL reconstruction was average 3.4mm. From the ahove results, PCL reconstruction with autogenous BPTB by the two tunnel technique seemed to be a valuable procedure, but there were some cases of unfavorable results. Authors think that a new graft fixation method is needed for resolving the problem mentioned above.