Arthroscopic anterior cruciate ligment reconstruction, patellar tendon versus four strand hamstring graft

This study included 40 male patients in the patellar tendon group and 40 patients [39 male and one female] in the hamstring tendon group. The rehabilitation program was standard in both groups, with immediate knee motion and early weight bearing. Preoperatively, no significant difference between the two groups was noted with respect to age, level of activity, duration of injury, degree of laxity and symptoms of instability. Patients were evaluated using the Lysholm knee score and the international knee documentation committee [IKDC] scores. The average follow up period was 24.6 months for the patellar tendon and 21.2 months for the hamstring tendon group. The final evaluation showed no difference between both groups with satisfactory result in 90% of PT group and 87.5% in the STG group as evaluated by Lysholm. Also, the IKDC evaluation showed no significant difference with 80% of PT group and 90% of the STG group. No significant difference was noted between the two groups with respect to ligament stability, functional evaluation and return to sports activity. Although thigh atrophy and loss of terminal degree of extension was more among patients of the PT group, the difference was not significant

Proximal open wedge tibial osteotomy fixed by puddu osteotomy plate combined with arthroscopic microfracture in medial gonathrosis of the knee with varus defomity

The material of this study consisted of 22 patients, 18 females and 8 males with a mean age of 46.4 years [range 35-50 years]. Preoperative physical examination included assessment of pain, tenderness, range of motion, varus deformity and presence of instability. Standing anteroposterior radiograph of both knees was performed to determine the degree of the tibio-femoral varus angle. All patients had arthroscopic debridement and micro-fracture for the degenerative cartilage combined with proximal open wedge osteotomy fixed by Puddu osteotomy plate. Autogenous bone graft was used to fill the wedges in all patients. Postoperatively the knee was mobilized in a CPM, patients were allowed non-weight bearing ambulation with knee brace. Partial weight bearing started at 6 weeks and full weight bearing at average 12 weeks. The combination of arthroscopic debridement and micro-fracture with proximal open wedge osteotomy fixed by Puddu wedge plate provided a simplified technique for treatment of medial gonarthrosis of the knee with varus deformity in patients less than 50 years old

Arthroscopic treatment of articular cartilage damage of the knee using a limited abrasion chondroplasty and microfracture

Fifty patients with limited extent of chondral damage of the femoro-tibial joint treated by arthroscopic debridment, limited abrasion chondroplasty and micro-fracture of the exposed bone. There were31 men and 19 women with an average age 45.7 years [range 22-65 years]. The duration of symptoms ranged between one to 10 years with a mean of 5.2 years. Patients were followed for an average 25.6 months [range 13 - 48 months]. The overall end result showed that 78% had either excellent or good result and remains good until last seen. There was significant improvement in pain, abilities for work activities, squatting, range of motion and swelling. Worst results were obtained in patients above 50 years, with affection of both condyles, associeated patello-femoral osteoarthritis and malalignment. The best result was found in patients below age of 40 years, with no varus deformity and a shorter period of complaints. There was no correlation between the outcome and the degree of damage of the articular cartilage and associated meniscal tears or ACL injuries. In Conclusion, The functional outcome was encouraging in most of the cases following the above procedure. The key for success is the proper selection of patients with limited disease and no malalignment. Microfracture is a cost-effective technique available to all arthroscopic surgeons using proper instrumentation with complications