ABSTRACT
INTRODUCTION: The surgical revision rate following anterior cruciate ligament (ACL) surgery is 3% at 2 years and 4% at 5 years. Revision ACL surgery raises the question of the type of graft to be used. The present study assessed return to sports and functional results after revision ACL reconstruction by fascia lata graft. The hypothesis was that fascia lata provides a reliable graft in revision ACL surgery. MATERIAL AND METHODS: A single-center retrospective continuous study included 30 sports players with a mean age of 26.8±8 years undergoing surgical revision for iterative ACL tear between 2004 and 2013. Multi-ligament lesions were excluded. Type and level of sports activity were assessed preoperatively, after primary surgery and at end of follow-up. Clinical assessment used subjective IKDC, Lysholm and KOOS scores. RESULTS: At a mean 4.6±1.6 years' follow-up, all patients had resumed sport activity, but only 12 with the same sport at the same level. Median subjective IKDC score increased from 57 [54.3; 58.5] preoperatively to 82 [68.3; 90] at last follow-up, and Lysholm score from 46 [42.3; 51] to 90.5 [80.8; 96.8]; KOOS score at last follow-up was 94.7 [83; 100]. CONCLUSION: Functional results in revision ACL reconstruction by fascia lata graft were satisfactory, with similar return-to-sports rates as with other techniques. Fascia lata provides a reliable graft in revision ACL surgery. LEVEL OF EVIDENCE: IV, retrospective study.
Subject(s)
Anterior Cruciate Ligament Injuries/surgery , Anterior Cruciate Ligament Reconstruction/methods , Athletic Injuries/surgery , Fascia Lata/transplantation , Reoperation/methods , Return to Sport/physiology , Adolescent , Adult , Anterior Cruciate Ligament Injuries/physiopathology , Anterior Cruciate Ligament Injuries/rehabilitation , Athletic Injuries/physiopathology , Athletic Injuries/rehabilitation , Female , Follow-Up Studies , Humans , Male , Middle Aged , Recovery of Function , Retrospective Studies , Transplantation, Autologous , Treatment Outcome , Young AdultABSTRACT
The presence of air within the spinal canal secondary to trauma is a rare condition. These rare cases are generally asymptomatic. We report our first case of closed thoracic trauma with pneumorachis associated with neurological disorders. According to a review of the literature and after personal record analysis, neurologic symptoms can be correlated to the occurrence of intraspinal air. Therefore pneumorachis appears as a possible cause of traumatic spinal cord compression. In this particular case, pneumorachis spontaneously resolved and early outcome was favourable.
Subject(s)
Spinal Cord Compression/etiology , Spinal Fractures/complications , Spinal Fractures/diagnosis , Thoracic Vertebrae/injuries , Humans , Male , Pneumothorax/complications , Pneumothorax/diagnosis , Pneumothorax/therapy , Spinal Cord Compression/diagnosis , Spinal Cord Compression/therapy , Spinal Fractures/therapy , Young AdultABSTRACT
Displaced four-part fracture dislocation represents the highest risk of osteonecrosis of the humeral head due to a disruption of the blood supply. In a few cases, that dislocation can be intrathoracic which worsens prognosis with life-threatening injuries such as hemothorax or pneumothorax. This paper presents the case of a 77-year-old woman after having fallen down the stairs with an intrathoracic dislocation four-part fracture leaving the head in the thorax. We analyze mechanisms and review the literature in order to highlight this lesion and provide a take home message for the treatment.
