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BACKGROUND:Anterior cruciate ligament (ACL) reconstruction is the primary treatment method for ACL rupture. Currently, studies on ACL reconstruction involve histology and embryology, anatomical structure, biomechanics, reconstruction materials, operating technology, and rehabilitation after reconstruction. However, clinical epidemiological studies describing ACL rupture and reconstruction remain scarce. OBJECTIVE:To analyze the clinical epidemiological characteristics of ACL rupture and reconstruction to provide guidance for prevention and treatment of ACL rupture. METHODS:Data of 352 patients forage, gender, cause and mechanism of injury,treatment time, and the impact of ACL rupture on menisci and articular cartilage were gathered. Meanwhile, the events during surgery, operation methods and reconstruction materials were analyzed. RESULTS AND CONCLUSION:ACL rupture mostly occurred in young men,andhappened more often to theleft knee; male patients got hurt in basketbal, footbal and accidental injuries,whilefemale patients got hurt in the accidental injuries, badminton and sking injuries, internal rotation with valgus stress accounted for the predominant injury mechanism. The ACL reconstruction wasmostlyperformedwithin1-3 months after ACL rupture, often accompanied by meniscal and articular cartilage damage. Lateral meniscus injury incidence was relatively stable, medial meniscusinjury incidence increased significantly over the half year after ACL rupture. Most articular cartilage injury occurred to patelar cartilage.Asignificant increase in medial condylar cartilage damage over 1 year after ACL rupturewas often observed. Anatomic single-bundle ACL reconstruction was the primary surgical approach, the resident ridge and the lateral bifurcate ridge could be used to position bone tunnel and autogenous semitendinosus and gracilis tendon were the most commonly used reconstructionmaterials. Our results indicate that anatomic ACL reconstruction should be performed as early as possibleinrestore knee joint stability and prevent secondary injury of the medial meniscus and cartilage of medial femoral condyle.
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<p><b>BACKGROUND</b>The tibial plateau is asymmetric with a larger medial plateau. We observed from clinical practice that the shape of the tibial plateau does not always present a larger medial plateau. Tibial plateau also showed other shapes. The purpose of this study was to analyze the anthropometric data of the proximal tibia in a large group of Chinese patients undergoing total knee arthroplasty and to investigate the morphology of the resected proximal tibial surface and its gender differences.</p><p><b>METHODS</b>A total of 822 knees (164 males, 658 females) from the Chinese population were measured intraoperatively for medial anteroposterior (MAP) and lateral anteroposterior (LAP) dimensions of the resected proximal tibial surface. The difference of MAP and LAP (DML) was also calculated as MAP minus LAP. We then classified the data into three groups based on the DML (<-2, -2 to 2, and >2 mm) to analyze the morphology of the proximal tibia and its distribution between male and female.</p><p><b>RESULTS</b>The shape of proximal tibial plateau was of three types: larger medial plateau type, symmetric type, and larger lateral plateau type. There were significant differences between males and females in relation to the shape distribution of the proximal tibial plateau (P < 0.05). Most of the proximal tibial plateau was asymmetric, with 517 of 822 (62.9%) tibia having a DML >2 mm and 120 of 822 (14.6%) tibia having a DML<-2 mm. Only 185 of 822 (22.5%) tibia had a DML between -2 and 2 mm.</p><p><b>CONCLUSION</b>The results of this study can be used as a guideline to design tibial components with different DMLs to better match the different anthropometry of the resected tibial surface.</p>
Subject(s)
Aged , Female , Humans , Male , Middle Aged , Anthropometry , Methods , Arthroplasty, Replacement, Knee , Methods , Asian People , Knee Joint , General Surgery , Sex Factors , Tibia , General SurgeryABSTRACT
Objective To investigate the effect of extracorporeal shock waves (ESWs) combined with expanding bone marrow autografts in treating nonunion of femoral shaft fractures with interlocking intramedullary nails.Methods Thirty patients with femoral shaft fractures which had not united were divided into an ESW group,an expanding bone marrow group,and a combined treatment group using a table of random numbers.Each group had 10 cases.In the ESW group,no expanding bone marrow was employed in fixing the intramedullary nails and ESW therapy was begun at day 14 after the operation.In the expanding bone marrow group,bone marrow was grafted around the broken ends of fractured bones.In the combined treatment group patients underwent both treatments.The conditions of the callus and the fracture lines in the 3 groups were separately evaluated using X-rays at the 4th,8th,12th and 16th week after the operation.Results At week 4,the average callus and fracture line scores in the combined treatment and expanding bone marrow groups were significantly better than those in the ESW group.At the 8th week after the operation,the average callus and fracture line scores in the combined treatment group were significantly higher than in the ESW group and expanding bone marrow groups.Later,the callus and fracture scores in all 3 groups continued to rise significantly.At the 12th and 16th week the scores in the combined treatment group were significantly better than those in the ESW group and the expanding bone marrow group,while the scores in the ESW group were significantly better than those in the expanding bone marrow group.The cure rates in the ESW,bone marrow and combined treatment groups were 60％,50％ and 100％ respectively at week 16.Conclusions The combined treatment was significantly more effective than either treatment alone.There was no significant difference in effectiveness between the ESW and expanding bone marrow treatments.ESW combined with expanding bone marrow autograft is an effective way to promote bone knitting in the treatment of nonunion of femoral shaft fractures with interlocking intramedullary nails.