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Objective To investigate the changes of bone tunnel and differences of clinical outcomes after anterior cruciate ligament (ACL) reconstruction with hamstring tendons from autografts and allografts. Methods The study involved in 61 patients with ACL injury undergone arthroscopic ACL reconstruction from June 2008 to November 2009.According to ACL graft differences,61 patients were assigned to two groups,ie,Group A ( reconstruction with tendon allografts,n =27 ) and Group B ( reconstruction with tendon autografts,n =34).MRI examination was performed one week and 6-12 months post-operatively to measure the sagittal bone tunnel diameters at the aperture location,at the location of 1cm away from the aperture and at the widest location of tunnel.Taking the bone tunnel diameter at each location one week post-operatively as the measurement criteria,the differences of bone tunnel diameters at each corresponding location were analyzed statistically.Lysholm score was used to evaluate the clinical effects in the two groups. Results Group A and B were followed up for average 8.4 months and 8.5 months,respectively.Pre-operative clinical data of the two groups had no significant difference.MRI follow-up showed that the tunnel diameters at femoral side and tibial side both had different degree of enlargement.Meanwhile,the enlargement degree at the tibial side was larger than that at the femoral side,with no statistical differences of the two groups regarding tunnel enlargement of the three measurement locations at femoral and tibial sides.Joint stability in all patients was good.The two groups showed no significant difference in Lysholm score after operation ( P ＞ 0.05 ). Conclusions Graft difference is a factor for bone tunnel enlargement after ACL surgery.Autologous and allogenic tendons show no difference in their role in bone tunnel enlargement after ACL surgery or correlation with clinical effects.
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[Objective]To compare the changes in femoral bone tunnel after arthroscopically assisted hamstring ACL reconstruction with different graft fixations and investigate the relation with clinical effect.[Method]Eighty-eight cases in three groups were included and underwent hamstring ACL reconstruction with different femoral graft fixations for average 16.5 months follow-up evaluation.Twenty-six cases in group A received Endobutton fixation,twenty-two cases(group B) received interference screw,and forty cases(group C)received Rigidfix system.Femoral bone tunnel diameters at the articular line level,the widest point,1 cm away from tunnel aperture on sagittal MRI were compared at one week postoperatively.Lysholm score was used to evaluate the clinical effect.[Result]Tunnel enlargement after ACL surgery was noted in the three groups.At the femoral widest point and 1 cm away from tunnel aperture,the tunnel enlargement was larger in group B and smaller in group C.At the femoral articular line level,the bone tunnel enlargement in group C was smallest.There was no difference between those of groups A and B.The shape of femoral tunnel was lineal in groups A and C,and conical in group B.No significant difference was found by Lysholm score.[Conclusion]The type of graft fixation is a major factor in the development of tunnel enlargement after ACL surgery.No correlation between graft fixation,bone tunnel enlargement and clinical effect has been found.
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[Objective] To introduce a method of arthroscopic synovectomy in chronic synovitis of the knee in patients with hemophilia A and to evaluate its clinical value.[Method]Arthroscopic synovectomy was performed in 25 patients with hemophilia A from Sept.2002 to Jan.2007.Sufficient factor replacement was used and systematic rehabilitation exercise was emphasized.HSS scores were used to evaluate the efficiency of the operation.Insall standard was used to determine the difference between groups according to Outerbridge grading of the cartilage.[Result]Twenty-three patients were followed up.The mean period of follow-up was 27 months.The average frequency of hemarthrosis reduced from 23.4 times per year preoperatively to 9.8 times per year postoperatively(P