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Objective To determine the effect of trunk motion control on knee biomechanics during single-leg landing. Methods Twenty male healthy basketball players were recruited. The kinematics, kinetics parameters and surface electromyogram (EMG) of knee joints under trunk motion control during single-leg landing were studied by using Vicon motion Analysis system, Kistler force platform and Noraxon surface EMG system. Results Compared with natural landing, there were significant differences in flexion angle at initial contact moment, peak flexion angle and peak flexion moment during deeply inspiratory landing and landing with a stick, and a significantly larger flexion angle at initial contact moment, a larger peak flexion angle and smaller peak flexion moment were also found. Compared with natural landing, there was no statistical difference in peak valgus angle and peak valgus moment, as well as EMG activity of hamstrings, quadriceps muscles of the knee during deeply inspiratory landing and landing with a stick. Conclusions Deeply inspiratory landing or landing with a stick reduce the risk of anterior cruciate ligament (ACL) injury, and the results provide the theoretical basis for prevention of ACL injuries in basketball players during landing.
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Objective To study the effect of gender and maneuvers on anterior cruciate ligament (ACL) injury risk factors for volleyball players. Methods Sports biomechanics data of volleyball players during stop-jump, drop landing and sidestep cutting were collected. The ACL injury rate and biomechanical parameters of simulated injured jumps were obtained with Monte Carlo simulation. The influence of gender and maneuvers on ACL injury risk factors was validated by 2×3 mixed designed two-way ANOVA. Results Sidestep cutting was the highest risk maneuver of ACL injury for both genders (P＜0.001). Compared with male players, female players had a greater risk of ACL injury during sidestep cutting and stop-jump (P＜0.001), while male players were more prone to have ACL injury than female players during drop landing (P＜0.001). The risk factors of ACL injury obtained by simulation were significantly influenced by gender and maneuvers (P＜0.001). Conclusions Male players were more likely to increase ACL load due to smaller knee flexion, forward leg tilt and heel landing than female players during sidestep cutting, while female players owned larger ground reaction force (GRF) and knee extension moment. Smaller knee flexion angle during stop jump was the major risk factor for both genders, however more characteristics contributed to the males. Female players with large GRF, knee valgus and extension moment, and heel-landing were likely to have ACL injury, while the small knee flexion angle was the key risk factor for male players. The results can provide evidences for evaluation of volleyball players’ ACL injury risk, individualized injury prevention protocols, and clinical treatment and rehabilitation directions.
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OBJECTIVE@#To observe the effect of electroacupuncture (EA) on the rehabilitation of knee joint function after anterior cruciate ligament (ACL) reconstruction.@*METHODS@#A total of 140 patients with ACL reconstruction were randomly divided into an observation group (58 cases recruited, 12 cases dropped out) and a control group (65 cases recruited, 5 cases dropped out). The patients in the control group were treated with routine rehabilitation treatment. The patients in the observation group, on the basis of the treatment in the control group, were treated with EA at Fengshi (GB 31), Futu (ST 32), Zusanli (ST 36), Shangjuxu (ST 37), Fenglong (ST 40), Xuanzhong (GB 39), Diji (SP 8) and Sanyinjiao (SP 6) on the affected side (2 Hz/100 Hz of dilatational wave, 2-5 mA). Each EA treatment lasted 20-30 min, twice a day for 7 days. The swelling degree (d), pain visual analogue scale (VAS), knee joint range of motion (ROM), scores of International Knee Documentation Committee (IKDC) subjective short form and scores of Lysholm were observed in the two groups 1 day, 1 month, 3 months, 6 months and 1 year after operation.@*RESULTS@#One month and 3 months after operation, the swelling degree (d) and VAS scores in the observation group were lower than those in the control group (0.05). One month, 3 months, 6 months and 1 year after operation, the ROM of the knee joint in the observation group was higher than that in the control group (<0.05), the IKDC score and Lysholm score were higher than those in the control group (<0.05). Within one year, there were no relaxations, fractures and other related complications in the two groups. The pivot shift test, anterior drawer test and the Lachman test were all negative.@*CONCLUSION@#EA combined with routine rehabilitation training could obviously reduce the pain of knee joint, improve the swelling degree, increase the ROM of knee joint, promote the functional recovery in patients with ACL reconstruction, which are superior to rehabilitation training alone.
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Department of Orthopedics, Yang Pu Hospital Affiliated to Tongji University,
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Anterior cruciate ligament (ACL) deficiency is a common clinical injury that seriously affects the function of the knee. Although ACL reconstruction (ACLR) can rebuild the structure of the ACL, it does not restore the normal kinematics and dynamics of the knee. In recent years, motion analysis has been widely applied in sports science and rehabilitation. In clinics, motion analysis is mainly applied to the evaluation of clinical outcomes of the ACLR knee. It is also a scientific objective tool to assess the potential risk factors of secondary injury and early onset of osteoarthritis after ACLR. In-depth understanding of the knee functional kinematics and kinetics after ACLR will significantly improve the efficacy of current ACL deficiency treatment and rehabilitation regime. This paper reviewed studies of the knee joint motion analysis after ACLR in the past decade. The current knowledge of the ACLR knee motion from studies using optical motion capture and biplanar fluoroscopic imaging system based tracking technique was synthesized. Clinical studies have reported that regardless of the type of graft and surgical technique of the ACLR, the postoperative knee still exhibits abnormal kinematics in functional tasks, but the relationship between early-onset OA and the biomechanical changes in the ACLR knee remains unknown. Restoring the rotational stability of the knee is still one of the biggest challenges in clinical ACLR surgery. Future studies should explore the impact of ACLR on the biomechanical mechanisms of the knee joint through an appropriate research design and long-term follow-up, and help clinicians and physiotherapists to develop more effective interventions.
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Background: The anterolateral ligament (ALL) originates from the lateral epicondyle of the femur and inserts onthe tibia in between Gerdy’s tubercle (GT) and fibula head (FH). The ALL exists as a ligamentous structure thatbecomes taut if tibia is rotated 30° medially. It has been suggested that the ALL of the knee has importance inlimiting rotational instability, and reconstruction of the same along with anterior cruciate ligament (ACL) mayprevent a continued pivot-shift following surgery. We describe our experience of cadaveric dissection withreference to other published.Materials and Methods: This study was conducted in Department of Anatomy, D.Y.Patil Medical College, Kolhapurfrom 2016 to 2018. The ALL was identified in 14 Females and 16 Males cadavers, total 60 knee joints. The ALLtissue was identified with internal rotation of the tibia. Measurements were made using a digital calliper anddetails of the origin and insertion were recorded.Results: The ALL was identified had mean dimensions were: length 38.06 ±3 mm on Right side and 37.94 ± 3 mmon Left side, width 4.38 ± 0.25 mm on Right side and 4.37 ± 0.25 mm on Left side, thickness 0.9 ± 0.02 mm on Rightside and 0.9 ± 0.02 mm on Left side. The femoral origin Posterior and Proximal (PP) in 23, Anterior and Distal (AD)in 29 and Femoral Lateral Epicondyle in 8 knee joint. The tibial insertion was a mean 1.79 ± 0.3 mm on Right sideand 1.82 ± 0.3 mm on Left side from Gerdy’s tubercle (GT) and 1.28 ± 0.03mm on Right side and 1.25 ± 0.03 mm onLeft side from the fibula head (FH).Conclusions: Our results go along the studies describing that the ALL is a capsular thickening and has meniscalattachment. The findings will help surgeon to perform reconstructive surgery and also help them to select theappropriate graft. Further, we feel this ligament should be added in all gross anatomy book so that medicalundergraduates are also aware of ALL.
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Objective To explore the operating methods and clinical effects of reconstruction of anterior cruciate ligament with LARS artifical ligament. Methods From October 2012 to June 2015,the clinical data of twenty-four patients with arthroscopic reconstruction of anterior cruciate ligament with LARS artifical ligamennt in Capital Medical University Beijing Friendship Hospital Pinggu Hospital were analyzed retrospectively. All patients underwent anatomical and isometric reconstruction of anterior cruciate ligament to drill femoral and tibial tunnel. The recovery of knee joint function was evaluated by Lysholm scoring system,and the clinical effect was observed. Results All 24 patients were available for follow-up with an average of ( 22. 5 ± 1. 5) months. No wound infection occurred during the period. Joint instability and weak leg symptoms and knee pain were obviously improved,the scope of joint activities was increasing. The Lysholm scores improved from a preoperative score of (40.20±1.26) points to postoperative (92.20±2.18)points,and the difference between the two groups was statistically significant (t＝2. 156,P＜0. 05). According to the modified Lysholm scoring standard,among 24 cases,15 cases were excellent,7 cases were good,2 cases were fair,and the excellent and good rate was 91. 6%(22/24). Conclusion The reconstruction of the anterior cruciate ligament with LARS artificial ligament has the advantages of small trauma, definite curative effect and less complications. It can achieve the purpose of anatomic reconstruction of the anterior cruciate ligament and can effectively restore the stability of the knee joint.
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PURPOSE: To evaluate the knee joint after double-bundle anterior cruciate ligament (ACL) reconstruction with three-dimensional (3D) isotropic magnetic resonance (MR) image, and to directly compare the ACL graft findings on 3D MR with the clinical results. MATERIALS AND METHODS: From January 2009 to December 2014, we retrospectively reviewed MRIs of 39 patients who had reconstructed ACL with double bundle technique. The subjects were examined using 3D isotropic proton-density sequence and routine two-dimensional (2D) sequence on 3.0T scanner. The MR images were qualitatively evaluated for the intraarticular curvature, graft tear, bony impingement, intraosseous tunnel cyst, and synovitis of anteromedial and posterolateral bundles (AMB, PLB). In addition anterior tibial translation, PCL angle, PCL ratio were quantitatively measured. KT arthrometric values were reviewed for anterior tibial translation as positive or negative. The second look arthroscopy results including tear and laxity were reviewed. RESULTS: Significant correlations were found between an AMB tear on 3D-isotropic proton density MR images and arthroscopic proven AMB tear or laxity (P < 0.05). Also, a significant correlation was observed between increased PCL ratio on 3D isotropic MRI and the arthroscopic findings such as tear, laxities of grafts (P < 0.05). KT arthrometric results were found to be significantly correlated with AMB tears (P < 0.05) and tibial tunnel cysts (P < 0.05). CONCLUSION: An AMB tear on 3D-isotropic MRI was correlated with arthroscopic results qualitatively and quantitatively. 3D isotropic MRI findings can aid the evaluation of ACL grafts after double bundle reconstruction.
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Humans , Anterior Cruciate Ligament , Arthroscopy , Knee Joint , Knee , Magnetic Resonance Imaging , Protons , Retrospective Studies , Synovitis , Tears , TransplantsABSTRACT
Objective To investigate the clinical effects of arthroscopic repair and reconstruction of anterior cruciate ligament repair (ACL) combined meniscus injury. Methods 40 cases of patients with anterior cruciate ligament (ACL) combined meniscus injury were selected, they were divided into experimental group (also repair ACL and meniscus), control group (meniscus repair), the Lysholm scores before and after surgery of the two groups, as well as the postoperative Lysholm scores of the two groups were observed. Then compared the meniscal healing rate after surgery and meniscal reoperation rate after 2 years of the two groups. Results The postoperative Lysholm score after surgery was higher than before surgery, but the Lysholm score of the experimental group was higher than that in control group. The healing rate of the experimental group was higher than that in control group, the meniscus reoperation rate after 2 years was lower than that in control group. Conclusion Arthroscopic repair and reconstruction of anterior cruciate ligament (ACL) and meniscus injury can improve the cure rate, is conducive to postoperative rehabilitation, and the long-term effect is obvious, so is worthy of promoting.
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Objective To analyze the present status, subject and characteristics of biomechanical studies on injury prevention of anterior cruciate ligament (ACL), which has a practical guiding significance in promoting prevention and control of ACL injuries. Methods Biomechanical studies on ACL injury prevention were conducted by scientometrics based on the Web of Science, CNKI database for statistic analysis. Results Cumulative numbers of issued papers on biomechanical studies of ACL injury prevention well complied with the exponential growth rule year by year in general, which mainly focused on sports science, orthopedic science, surgery, rehabilitation and other disciplines. From the countries participating in the studies, the United States of America was unique, followed by Canada, UK and Japan. Timothy E. Hewett contributed the largest number of issued papers among all the authors participated in the studies. Topics of biomechanical studies on ACL injuries could be identified into four groups: risk factors and incidence, ACL injury of the female, neuromuscular training and control, ACL injury assessment. Conclusions Researchers should broaden their research fields, take advantage of the national and local governments to lead the role in the rehabilitation medical treatment, and pay more efforts in biomechanical studies of ACL injury prevention.
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Introducción: La reconstrucción del LCA es uno de los procedimientos ortopédicos más comunes. Los tornillos por interferencia biocompuestos están integrados por un polímero y algún material osteoconductor, cuya función es promover el crecimiento óseo en el sitio del implante al mismo tiempo que éste se reabsorbe. Material y método: se incluyeron un total de 28 pacientes, operados de reconstrucción artroscópica de LCA fijados con tornillo Milagro y tornillo bio-intrafix. Todos los pacientes fueron valorados con TAC, se realizaron mediciones del diámetro del túnel tibial en el segmento proximal, medio y distal, con trazo libre utilizando por lo menos 10 puntos de referencia para cada trazo. Así como una valoración subjetiva en relación a la presencia o ausencia de esclerosis adyacente al tornillo. Resultados: del total de la muestra, 12 pacientes no presentaron datos de osteointegración y 16 pacientes sí, encontrándose una asociación significativa entre osteointegración y el tornillo Milagro (p=0.006). En cuanto a degradación, no se observó ningún paciente sin datos de degradación. 53 por ciento se catalogaron como degradación parcial y 47 por ciento como total, de éstos el 76.9 por ciento pertenecían al grupo con tornillo Milagro encontrándose así una asociación entre el tornillo Milagro y degradación (p=0.006). Discusión y conclusiones: el tornillo Milagro fue el que se asoció con osteointegración. El área total en el túnel tibial incrementó, siendo éste porcentaje mayor para el tornillo bio-intrafix. Sin embargo, no se encontró una relación lineal entre el tiempo transcurrido desde la cirugía y el cambio en el área del túnel tibial; sugerente de que existen otros factores que influyen en este proceso. A pesar de los resultados clínicos satisfactorios, la adición de una cerámica osteoconductora no resultó en osteointegración completa de ninguno de los tornillos. Nivel de evidencia: III. Tipo de estudio: Cuasiexperimental, transversal, ambilectivo.
Introduction: The ACL reconstruction is one of the most common procedures in orthopedics. The bio-interference screws are made of a polymer plus an osteoconductive ceramic which function is to promote bone formation at the site of the implant while it reabsorbs. Methods: 28 patient were included, all were submitted to an arthroscopic ACL reconstruction procedure. CT scans were made in all of them, the diameter of the tibial tunnel was measured at the proximal, medial, and distal segments by a 10 point reference free hand line. Also a subjective evaluation was made in relation to the presence of adjacent sclerosis at the screw. Results: from the total sample, 12 patients did not show signs of osseointegration, 16 did, finding a significant association between osseointegration and the Milagro screw (p=0.006). None of the patients had absence of degradation. 53% were classified as partial degradation and 47% as total, from these the 76.9% belong to the Milagro screw group resulting in an association between the Milagro screw and total degradation (p=0.006). Discussion and conclusions: the Milagro screw was associated with osseointegration. The total area of the tibial tunnel increased, being this percentage major for the bio-intrafix screw. Hence, a linear relation was not found between the time from intervention and the change at the area of the tibial tunnel though, suggesting there are other factors that influence this process. Beside the satisfactory clinical results, the addition of an osseoconductive ceramic did not result in a complete osseointegration of neither screw. Level of evidence: III. Type of study: Cuasi experimental, transversal, ambilective.
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Middle Aged , Arthroscopy/methods , Absorbable Implants , Anterior Cruciate Ligament/surgery , Anterior Cruciate Ligament , Osseointegration , Tomography, X-Ray Computed , Knee Injuries , Treatment Outcome , Bone Screws , Knee Injuries/surgeryABSTRACT
Introduction The incidence of knee injuries is very high in young adults. Anterior cruciate ligament (ACL) rupture is the most frequent of them. The isokinetic dynamometry evaluation determines the functional patterns of strength and muscle balance.Objective To compare the isokinetic hamstring/quadriceps peak torque and work ratios of young adults after surgical reconstruction of the anterior cruciate ligament.Methods We selected 33 medical records filed by the Isokinetic laboratory of the Physiotherapy Clinic of the Catholic University of Paraná (PUCPR), which belonged to patients who had undergone isokinetic assessment at the request of a physiotherapist or physician in Curitiba, Paraná. The tabulated data were: Hamstring/Quadriceps peak torque and work ratios of all injured and non-injured limbs at an angular velocity of 60°/s. Data were processed by the statistical software LHstat. Inferential statistics was used in order to apply the comparison test between means (unpaired t-test) with a confidence interval of 95%.Results The average flexion-extension ratio of the non-involved limb was lower than the involved limb both for peak torque (peak torque ratio of the non-involved limb: 56.1%; peak torque ratio of the involved limb: 66.3%; difference: 10.2%) and work (work ratio of the non-involved limb: 60.1%; work ratio of involved limb: 66.1%; difference: 6%).Conclusion : The average flexion/extension ratio found was adequate for both limbs and variables, however, the subjects presented a greater number of muscle asymmetries in the involved limb than in the non-involved limb.
Introdução A incidência de lesões de joelho em adultos jovens é muito alta, sendo a ruptura do ligamento cruzado anterior (LCA) a mais frequente. A avaliação por Dinamometria Isocinética determina o padrão funcional de força e equilíbrio muscular.Objetivos Comparar a relação das variáveis isocinéticas torque e trabalho de flexores e extensores do joelho em adultos jovens após a reconstrução cirúrgica do ligamento cruzado anterior. Metodologia: Foram selecionados 33 prontuários arquivados pelo laboratório de Isocinética da Clínica de Fisioterapia da Pontifícia Universidade Católica do Paraná (PUCPR), de pacientes que realizaram a avaliação isocinética a pedido de fisioterapeutas e de médicos da cidade de Curitiba (PR). Os dados tabulados foram: relação flexora/extensora de pico de torque e trabalho em todos os membros lesionados e não-lesionados a uma velocidade angular de 60°/s. Os dados foram tratados pelo software de estatística LHstat. A estatística inferencial foi empregada para aplicar o teste de comparação entre médias (Teste t não pareado) com um intervalo de confiança de 95%.Resultados A média da relação flexo-extensora é menor no membro não envolvido tanto no pico de torque (relação pico de torque do membro não envolvido 56,1% e relação do pico de torque do membro envolvido 66,3%, apresentando diferença de 10,2%) quanto no trabalho (relação do trabalho no membro não envolvido 60,1% e relação do trabalho do membro envolvido 66,1% apresentando diferença de 6%).Conclusão A média encontrada da relação flexo-extensora foi adequada para ambos os membros e variáveis, no entanto os indivíduos apresentaram assimetrias musculares em maior número no membro envolvido do que no membro não envolvido.
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Objective To investigate the effect of mechanical properties of anterior cruciate ligament (ACL) on finite element simulation of knee joint. MethodsA three-dimensional finite element model of knee joint including all the main tissues was reconstructed based on medical images, and the transverse isotropic hyperelasticity of ligament was considered as well. Three groups of ACL material property parameters were acquired by fitting three different experimental stress strain curves based on the same ligament constitutive equation, to compare the influence of different ACL mechanical parameters on the kinematic and biomechanical properties of knee joint. Results Different ACL mechanical properties resulted in different displacements in knee joint. With the change of ACL mechanical properties, the stress and principal strain in ACL changed a lot, while the trend of their distributions were basically the same. Conclusions The selection of different ACL experimental stress-strain curves can influence the simulating result of the finite element analysis. More attention should be paid to the determination of ACL mechanical properties, the reconstruction and validation for the finite element model of knee joint.
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PURPOSE: To compare the clinical results of anterior cruciate ligament(ACL) reconstruction between the bone-patellar tendon-bone(BPTB) autograft and the allograft. MATERIALS AND METHODS: The clinical results of thirty-three patients of BPTB autograft and thirty-six patients of BPTB allograft performed between the periods of May 1994 and March 2004 were compared retrospectively in terms of Lysholm score, IKDC knee rating system, Tegner scale, physical examination, and KT-1000 arthrometry. Minimum follow-up period was 2 years(range: 24 to 144 months, average: 51.9 months). RESULTS: The postoperative Lysholm score at final follow-up was 89.4 in autograft group and 90.1 in allograft group on average. The difference between the two groups was not significant statistically in postoperative Lysholm score, IKDC knee rating system, and Tegner scale. Twenty-seven cases(81.8%) of autograft group had a negative Lachman test versus thirty-one cases(86.1%) of allograft goup, postoperatively. There was no significant difference in Lachman test, flexion-rotation-drawer(FRD) test, pivot shift test, and KT-1000 arthrometry between the two groups. CONCLUSION: The clinical results of ACL reconstruction using the BPTB autograft or allograft was equally good without statistically significant difference.
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Humans , Allografts , Autografts , Follow-Up Studies , Knee , Physical Examination , Retrospective StudiesABSTRACT
[Objective]To investigate the technique and significance of arthroscopic anterior cruciate ligament(ACL) reconstruction with the remaining bundle and ruptured fiber.[Method]In 47 cases of ACL rupture verified with arthroscopy,there were 15 cases of partial disruption,26 cases of complete disruption,and 6 cases of ligament flabby.ACLs were reconstructed with single bundle of autogenous quadrupled hamstring tendons under arthroscopy without remove of the remaining bundle or remnants of ACL.The femur tunnel was fixed by the RigidFix system,and the Intrafix system was used to fix the tibia tunnel.[Result]All of 47 cases were followed up for an average of 19 months(ranged from 12 to 24 months).The stabilization was strengthened after operation.Lysholm knee function score increased by 26.3 scores,from average 68.6 scores of preoperation to average 94.9 scores after operation.Lachman test was negative in 43 cases,weakly positive in 3 cases and positive in 1 case.According to Insall knee therapeutic effect evaluation criterion,38 cases achieved excellent results and 9 cases achieved good results.[Conclusion]Arthroscopic reconstruction of ACL with the remaining bundle preserving technique could facilitate revasculization and reinnervation of the reconstructed ligament and maintain stability of knee joint.
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[Objective]To explore the biomechanical effects of preserving the remnants in anterior cruciate ligament(ACL) reconstruction under sealing the bone tunnel.[Method]Twelve skeletally matured New Zealand white rabbits underwent ACL reconstruction with preserving the remnants and sealing the bone tunnels on one knee randomly,the opposite knee was served as the paired control―ACL reconstruction with removing the remnants and sealing the bone tunnels.Rabbits were sacrificed at 12 weeks.The maximum loading of the femur-graft-tibia complexes were determined in 858 Mini BionixⅡtestor,and the rupture site was observed.[Result]The mean maximum load at 12 weeks was (23.46?7.4)N in the preserving remnants group,(18.63?4.26)N in the removing remnants group,the maximum load in the expermental group was 126% of the control.There was significant difference between two groups (t=3.058,P
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[Objective]To investigate the feasibility of the fabrication of tissue-engineered anterior cruciate ligament(ACL)in vitro by studying biocompatibility and mechanical property of the braided polyvinyl alcohol(PVA)materials.[Method]Firstly,human ACL cells and NIH3T3 cells were isolated,expanded in vitro and seeded onto the surface of the braided PVA scaffold materials,the adhesion,proliferation and three-dimensional growth of cells on the scaffold were observed by SEM.Secondly,the biomechanical properties of the braided PVA scaffold materials were measured with electro-biomechanical machine.[Result]The braided PVA scaffold materials had no cytotoxicity,ACL and NIH3T3 cells adhered,grew and proliferated well both on the surface and in the holes of the braided PVA scaffold materials.The maximum load,the maximum strain and ultimate tensile stress of the braided PVA scaffold materials respectively were 169.78?9.18N,11.67?1.38% and 52.21?2.88MPa.[Conclusion]The braided PVA scaffold materials possess good biomechanical properties and biocompatibility,it may become an ideal biomaterial for fabricating tissue-engineering ACL if the biomechanical properties can be improved.
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[Objective]To explore the operating methods and rudimental clinical effects of reconstruction of anterior cruciate ligament(ACL) with the ligament advancement reinforcement system(LARS) artificial ligaments under arthroscope.[Method]Since June of 2006,15 patients(11 males and 4 females,with an average age of 26.8 years)with acute ACL rupture have been treated with the LARS artificial ligaments.The results of preoperative Arto-scan of all patients suggested discontinuation of ACL.The average score of Lysholm on knee joint was 50 points.The operations were completed under arthroscope.Bone tunnels of the femur were located at the central point of arc on the medial surface of ectocondyle of 140 degree.Bone tunnels of tibia were located between the medial and lateral condyle on the tibial plateau、2-4 mm to summit line of fossa intercondylica.The diameter of the bone tunnels was 7.5 mm while that of LARS ligament and hollow crushing screw were 8 mm.[Result]All 15 patients were available for follow-up with an average of 18 months.No postoperative complications such as infection,ligament rupture,ligament loosening occurred.The clinical results were graded as being excellent in 8 patients,good in 5 and fair in 2 according to the Lysholm's classification.The excellent and good rate was 86.6%.[Conclusion]The anatomical reconstruction and the stability of the knee joint can be obtained after ACL reconstruction with LARS artificial ligaments.The operation under arthroscope has advantages of less-injury,rapid recovery and satisfactory curative effect.
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[Objective]To study and evaluate the result of the surgical treatment for arthroscopic reconstruction of anterior cruciate ligament(ACL) with double-bundle semitendinosus.[Method]Thirty-one cases who underwent surgical treatment of arthroscopic reconstruction of ACL with double-bundle semitendinosus during 1990～1998 were analyzed retrospectively.The mean follow up time was 127.36 months(98～168 months).Among them,11 case was simplicity ACL injury,15 cases associated with medial meniscus injury,8 cases combined with lateral meniscus injury,6 cases combined with medial collateral ligament injury,2 case combined with lateral collateral ligament injury.All the patients with medial collateral ligament injury were associated with medial meniscus injury.The analysis was performed on the symptom,physical sign,Lysholm score system and IKDC score pre and postoperation recently.[Result]All the patients had good clinical results with no click,locking,"give way",extra-extension pain,and floating patella test were negative.There were no other complications correlated with semitendinosus grafting.But mild pain were seen in 11 cases,Lachman test were positive in 3 cases,anterior drawer test were positive in 8 cases without complications of instability.The Lysholm score:preoperation was 49.62?8.22 and 76.60?7.68 in follow-up time(P
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[Objective]To explore the operating methods and key points of bysteel-wire guiding fixative steel-wire repearing tibial intercondylar eminence avulsion fractures under arthroscope.[Method]From February 2006 to August 2006,14 patients with tibial intercondylar eminence avulsion fractures were treated in bysteel-wire guiding fixative steel-wire method.Among them,there are 9 males and 5 females with an average age of 32.6 years,aged from 5 to 40 years.Injury cause:7 of road accident,5 of falling down while moving and 2 of falling from height.The results of preoperative x-Ray and Artoscan of all patients suggested the avulsion fracture of anterior cruciate ligament from the tibial spine.In the operation,firstly,fixative steel-wire cross the avulsion fracture tendon-bone joint zone.Then,make each side of avulsion fracture a bone tunnel on the tibial plateau.Finally,guide fixative steel-wire out of these two bone tunnels and then fix this steel-wire with the help of guiding steel-wires.After operation,fix the knee joint with plaster slab bended at 20? in three or four weeks.Remove the plaster slab and do functional exercise after 4 weeks.And move with walking stick 8 weeks later.[Result]All 14 patients were available at follow up with mean duration of 10.5 months.The X-Ray suggested bone healed at about 5.5 months after operation.We got the excellent in 8 cases,good in 4 and fair in 2 according to the advanced Lyshdm's classification at the last follow up.The excellent and good rate was 85.1%.[Conclusion]The technique needn't traditional cut,and has many advantages,such as micro injury,rapid recovery and few complications.And it is good to master the main points of this technique for applying it.