Research on preventing the tendon adhesion by using bFGF/vitamin C composite biodegradable membrane / 中国综合临床

ObjectiveTo investigate the feasibility of preventing tendon adhesion by using bFGF/ vitamin C composite biodegradable membrane.MethodsSixty Newzerland rabbits were divided into experimental and control groups randomly.After the animal model was established, the tendon autografts were encapsulated with the bFGF/vitamin C composite biodegradable membrane in experimental group, while no tendon autografts encapsulation in control.Three weeks after surgery, regular HE staining and AgNO3 staining were performed to observe the fibroblast nuclei and vitamin C.The quantity of collagen fibrils was measured by Luzex-F Image Analyzer.Eight weeks after surgery, the peritendinous adhesion and the maximum tensile load were analyzed.Results At 3 weeks after surgery, the numbers of vitamin C granules, fibroblast nuclei and collagen fibrils in the experimental group were significantly more than those in the control group(t = 11.78 ,P ＜0.001) .At 8 weeks after surgery, the peritendinous adhesion in the experimental group was significantly slighter than that in the control group(Z =3.922,P ＜0.005) ,and the maximum tensile load in the experimental group was significantly higher than that in the control group (t = 8.39, P ＜ 0.001) .ConclusionbFGF/vitamin C composite biodegradable membrane can stimulate the proliferation of fibroblasts and synthesis of collagen fibrils,improve the biomechanical property of tendon autografts and prevent the tendon adhesion.

Differences of clinical results of anterior cruciate ligament reconstruction between two different transplants / 中国矫形外科杂志

0.05).[Conclusion]Patients undergoing ACL reconstruction with non-irradiated deep-frozen allograft or autograft had similar clinical outcomes.Non-irradiated allograft is a reasonable alternative choice to autograft for ACL reconstruction.

Second-look arthroscopy following anterior cruciate ligament reconstruction with a hamstring tendon autograft / 中国微创外科杂志

Objective To arthroscopically re-observe the remodeling and maturity process following anterior cruciate ligament(ACL) reconstruction with a hamstring tendon autograft.Methods Thirty-three patients who had undergone a previous arthroscopic ACL reconstruction with a homolateral hamstring autograft were given a second observation under arthroscope.The interval from initial reconstruction to second-look arthroscopy ranged 2~36 months(mean,11.9 months).According to different intervals,the patients were grouped as 1~,4~,7~,10~,13~,18~,and 25~ months.The shape,color,tension,covering synovial tissue,and vascularity of the grafts were evaluated.Results As the interval increased,the hamstring grafts tended to progress to normal ACL morphologically.Under arthroscopic observation,the tendon grafts were characterized as grayish-white thick ligamentous tissues without synovial membrane and blood vessels after 7 months following initial reconstruction,which corresponded with the maturation period of autogenous grafts and simulated normal ACL.Conclusions Remodeling and maturation of the hamstring autografts progresses with time,which is comparable to patellar tendon autografts.

Correlation Between Patients 'Satisfaction and Objective Measurement after ACL Reconstruction

PURPOSE: The aim of this study was to correlate patients 'satisfaction with the objective measurement of the knee stability after a ACL reconstruction using a patellar tendon autograft. MATERIALS AND METHODS: Contact was made with 120 patients who a ACL reconstruction using a patellar tendon autograft on unilateral ACL rupture between January 1995 and April 2002 by single surgeon. Assessment was made by the KOOS score, Tegner score, Lysholm score, patients 'satisfaction, IKDC score, manual physical examination, one leg hop test and radiologic AP translation. Paired t-test, Pearson product moment correlation(PPMC) and Spearman 's rank correlation test were used to test the correlation between the parameters. RESULTS: Radiologic AP translation showed a statistically significant correlation with manual lachman and pivot shift tests. The Lysholm score had a high correlation with the patients 'satisfaction and one leg hop test. The final IKDC evaluation system showed the highest correlations with the Lysholm score, the patients 'satisfaction, the Tegner score, the manual lachman test, one leg hop test. Resumption of sports and work according to the Tegner score correlated with the patients 'satisfaction but had a very low correlation with manual lachman test. The knee laxity measurement using manual lachman test correlated with neither one leg hop test nor the patients 'satisfaction. The one leg hop test correlated with the Lysholm score, the patients 'satisfaction, the final IKDC evaluation system. CONCLUSION: We conclude that the final IKDC evaluation system is a very reliable tool and the patients 'satisfaction is important for evaluating the results after ACL reconstructiuon. And the one leg hop test also appear to be a reliable way of evaluating the functional outcome of the ACL reconstruction.

Second-Look Arthroscopy after ACL Reconstruction: Comparison of Patellar Tendon Autografts with Hamstring Tendon Autografts / 대한정형외과학회잡지

PURPOSE: To evaluate the healing status of reconstructed anterior cruciate ligament (ACL) and meniscal repair through second-look arthroscopy after arthroscopic reconstruction of the ACL. MATERIALS AND METHODS: We analyzed 81 cases by second-look arthroscopy among 397 cases that received ACL reconstruction during the period from June 1996 to December 2000. Second-look arthroscopy was conducted on average 18.8 months after reconstruction. 53 cases received a patellar tendon autograft, 28 cases received a hamstring tendon autograft and 29 cases received meniscal repair. We measured graft tension using displacement by probing, and synovial coverage by visual analysis at second-look arthroscopy. The improvements in Lysholm knee scores and KT-2000 arthrometer results were evaluated to compare patellar and hamstring tendons. RESULTS: The patellar tendon group showed normal tension in 41 cases and lax tension in 12 cases. The hamstring tendon group showed normal tension in 22 cases and lax tension in 6 cases. In the patellar tendon group, synovial coverage was good in 38 cases, half in 4 cases, and pale in 11 cases, whereas the hamstring tendon group was good in 25 cases, half in 2 cases, and pale in 1 case. Synovial coverage was better in the hamstring tendon group (p<0.05). Although there was no statistical significance, the hamstring tendon group was superior to the patellar tendon group in terms of graft tension, Lysholm knee scores and KT-2000 arthrometer results. CONCLUSION: The hamstring tendon group with ACL reconstruction was superior to the patellar tendon group, but long term follow-up will be necessary to further evaluate results.

Reconstruction of the Anterior Cruciate Ligament using an Achilles Tendon Autograft: Preliminary Study / 대한정형외과학회잡지

Reconstruction of cruciate ligament has been controversial. Autogenous grafts has been used with inconsistent success rates due to their variable strength and limited length. If any autograft could cover such drawbacks it could surpass the advantage of artificial ligaments also. Recently, we used partial Achilles tendon autograft in reconstructive operation of anterior cruciate ligament with promising result. The main advantages of this Achilles tendon autograft are its sufficient length and strength. Preliminary study was done in 11 patients who received reconstruction of the anterior cruciate ligament using partial Achilles tendon autograft. The results were as followings :l. Anterior cruciate ligament reconstructions were done in 11 patients, with follow-ups ranging from 5 to 12 months, average being 8 months. 2. Average preoperative knee score was 49.1, and it was improved up to 87.4 after operation. 3. Among the 11 patients, 6 belonged to the Excellent, 4 to good, and 1 to fair. 4. Achilles tendon autograft turned out to be a good autograft substitute for the anterior crucate deficient knee. The results were promising. Long-term follow-up is needed to confirm the final status of the operated knee.

A Retrospective Study of the Anterior Cruciate Ligament Reconstruction Using Patella Tendon:Allograft Versus Autograft / 中国运动医学杂志

Objective To compare the clinical outcomes of anterior cruciate ligament(ACL)reconstruction by using allograft and autograft of patella tendon.Methods From August 2003 to December 2005,82 ACL reconstruction patients were studied retrospectively,including 59 cases using autograft of patellar bone-tendon-bone(BPTB)and 23 cases using BPTB allograft.Physical examination,scores of IKDC,Lysholm-Tegner and VAS as well as KT-2000 measurements were used for evaluation pre-and post-operation.Results 41 autograft and 17 allograft patients were finally followed up.One allograft patient suffered re-rupture of the reconstructed ligament.Positive ADT test were found in 5 autograft and 1 allograft patients and positive Lachman test were found in 3 autograft and 1 allograft patients.No statistically significant differences were revealed in ROM.IKDC,Lysholm-Tegner Score and KT-2000 measurements showed no significant differences between two groups,but VAS for autograft group were significantly higher than allograft group(P