Bone tunnel enlargement after anterior cruciate ligament reconstruction / 대한정형외과학회잡지

PURPOSE: To evaluate the bone tunnel enlargement after an anterior cruciate ligament reconstruction (ACLR), We compared the results between a group that had a bone-patellar tendon-bone (BPTB) autograft (group 1) that included the nubbin and one that had a hamstring double looped autograft (group 2). MATERIALS AND METHODS: We evaluated 120 knees over a one year follow-up period. In group 1, the tibial tunnel was completely filled with nubbin. The clinical results were evaluated using the IKDC knee rating system and a KT-2000 arthrometer. Changes in the bone tunnel width on ordinary radiographs were measured periodically. RESULTS: Clinically, there was no significant difference between the two groups. In group 2, more tunnel enlargement occured (p<0.05). ACLR that included the nubbin in the BPTB autograft showed better results in the tunnel enlargement than the others. CONCLUSION: ACLR using the nubbin at the BPTB autograft is one of the solutions available for prevention of bone tunnel enlargement after ACLR.

Osteochondritis Dissecans of the Femoral Condyles Treated with Operation in Adults

PURPOSE: Up to now, there are several controversies in many aspects of osteochondritis dissecans. In this paper, we have intended to evaluate the frequent location and the etiology of the osteochondritis dis-secans of the femoral condyles, and to assess the adequate modality of operative treatment and its results according to the modality. MATERIALS AND METHODS: We reviewed retrospectively forty-four knees in forty patients. We analysed their clinical and radiological finding to take the incidence at both condyles and its etiology and to estab-lish the modality of applied operative methods according to the status of the lesion. The performed operative methods were multiple drilling(1 case), fragment fixation(2 cases), curettage & multiple drilling(36 cases), osteochondral autotransplantation(5 cases). The majority of these operation was proceeded under arthroscopy. Its clinical results were assessed by Aichroth's result grading system after an average follow-up of two-years and eleven months(range, one year and two months to six years and one month). RESULTS: Twenty one cases were medial femoral condylar lesions, and 23 cases were lateral. 91% patients had had the history of the definitive trauma(20 cases) or the minor repetitive trauma in their envi-ronments(20 cases). After operative treatment, seven knees had an excellent result; twenty-nine, a good result; six, a moderate result; and two, a poor result. Satisfactory result was 82%. CONCLUSIONS: On the basis of this review, we suggest that there is no difference in incidence between both femoral condyles, and that the trauma is seemed to play a major role as an etiologic factor. Majority of operated patients showed satisfactory results after application of our treatment modality.