Does Kinesiology Taping Improve the Early Postoperative Outcomes in Anterior Cruciate Ligament Reconstruction? A Randomized Controlled Study.

OBJECTIVE: The efficacy of kinesiology taping in arthroscopic knee surgery has not been reported. The objective of this study is to investigate the efficacy of kinesiology taping in the early postoperative phase after anterior cruciate ligament reconstruction (ACLR). We hypothesized that kinesiology taping reduces knee pain and swelling and improves knee range of movement and functional outcome. DESIGN: Randomized controlled study. SETTING: Primary Institutional Hospital. PATIENTS: Sixty subjects who underwent an elective ACLR with or without concurrent meniscectomy were randomized into intervention (with kinesiology taping postsurgery) and control groups. INTERVENTIONS: Subjects from both groups received standardized postoperative physiotherapy. Subjects from the intervention group received additional kinesiology taping on the first and second weeks postsurgery, each application lasting 5 days. MAIN OUTCOME MEASURES: Pain visual analogue score (VAS), total range of motion (ROM) of the knee, Lysholm-Tegner scale, and mid patella circumferential girth were measured before the surgery and at the first, second, and sixth week postsurgery. RESULTS: Within each group, statistically significant differences were found in all study parameters in both groups. Comparison of the study parameters between both groups revealed no statistical significance at various time points except the reduction of pain in the taping group in the early postoperative phase (between the first and second week) (P < 0.05). CONCLUSIONS: This is the first randomized controlled study investigating the efficacy of kinesiology taping in arthroscopic knee surgery. Our study showed that kinesiology taping reduced pain in the early postoperative period after ACLR. There was no statistical significance in the reduction of swelling or improvement of knee score and total range of motion with kinesiology taping.

Comparative study of magnetic resonance imaging (MRI) parameters in a Southeast Asian population with symptomatic patellofemoral instability.

BACKGROUND: MRI is performed for evaluation of soft tissue injuries associated with patellar instability. METHODS: Retrospective review of MRI parameters from a study group of 64 patients with symptomatic patellofemoral instability and a control group of 64 patients with acute knee injury without concomitant patellofemoral instability was performed. RESULTS: The study group demonstrated statistically significant increase (P<0.05) in all the MRI measurements compared to the control group. There were good inter-observer correlations between surgeon and radiologist for all radiological measurements. CONCLUSIONS: It is prudent to exercise caution in interpreting radiological parameters in different ethnic groups bearing as current treatment protocols are not ethnic-group specific.

Comparative study of the use of computer assisted navigation system for axial correction in medial unicompartmental knee arthroplasty.

The aim of our study was to compare the use of the Orthopilot Navigation system with conventional non-navigation technique for medial UKA with respect to the intraoperative mechanical limb alignment measurements and correlation with the postoperative radiological measurements. The postoperative mechanical limb alignment axes of 51 consecutive medial unicompartmental knee arthroplasty performed by a single surgeon over a 12-month period were measured. The cases were randomly assigned to two groups of which 21 cases were performed using conventional non-navigation based technique and 30 cases were performed using the Orthopilot Navigation System. Computed tomography (CT) scanogram was performed for all cases within the same hospitalization stay to assess the postoperative mechanical limb alignment. Our results showed that the non-navigated group had a more neutral mechanical axis with a narrower range compared to the navigation assisted group. The difference in the mean mechanical axis between the two groups was statistically not significant. There was poor correlation between the intraoperative navigation system measurements and the postoperative radiological measurements. In conclusion, the use of computer navigation in UKA is not as well validated as compared to TKA. We did not demonstrate any improvement in postoperative axial limb alignment measurement in using a computer navigation system compared to conventional non-navigation technique.

Living related donor allograft for revision anterior cruciate ligament reconstruction in a child: a case report.

Revision ACL reconstruction poses several challenges for the surgeon in terms of the timing of surgery and the limited graft choices. To our knowledge, there is currently no published data with regards to revision ACL reconstruction in a child. We describe the case of a 12-year-old girl who had a re-injury 4.5 months after her index primary ACL reconstruction at the age of 11 years. She sustained a repeat injury to the reconstructed knee following a road traffic accident and developed significant instability despite an intensive rehabilitation program. After careful consideration of the available graft materials--known all the advantages and disadvantages of the autografts, allografts and synthetic materials--we decided to use the patient's mother's hamstrings as a graft. The parents of our patient refused the use of allograft and synthetic materials. We discuss our management of this case, the reasons for our revision graft choice, and the theoretical disadvantages of some of the alternative graft choices available in this scenario. We believe in such cases, performing ACL revision with a donor graft of the patient's mother could be good alternative to allografts or synthetic grafts.

Anatomical study of the human anterior cruciate ligament stump's tibial insertion footprint.

The aim of this study is to define the topographical relationship of the anatomical bundles of the human anterior cruciate ligament's (ACL) stump over the tibial insertion site. Between January and April 2007, a total of 36 resected tibial plateaus were retrieved from patients who underwent total knee replacements. These samples had intact cruciate ligaments with no major osteophyte around the ACL tibial insertion footprint. The anatomical bundles of the ACL were identified and mapped, based on the topographical relationship over the tibial insertion footprint. Measurements of the dimensions of the ACL tibial footprint and tibial plateau were performed. The mean width and midsagittal depth of the tibia plateau was 78.7 +/- 6.5 and 46.4 +/- 5.0 mm, respectively. The mean width and midsagittal depth of the ACL tibial footprint was 10.3 +/- 1.9 and 19.5 +/- 2.6 mm, respectively. Out of the 36 freshly dissected ACL stumps, it was not possible to distinguish separate bundles in 14 (38.9%) cases. The average distance between the centers of the two bundles was 9.3 +/- 1.8 mm. The mean AP alignment of the tibial footprint was 89.6 degrees +/- 26.4 degrees , with a very wide range of 23 degrees -158 degrees . Of the 22 specimens with separate anatomical bundles, the alignment of the tibial footprint was AM-PL in six (27.3%), sagittal (85 degrees -95 degrees ) in five (22.7), AL-PM in nine (40.9%), and lateral-medial (L-M) in two (9.1%) cases. This study provides new information about the topographical anatomy of the ACL tibial insertion footprint. Based on gross anatomy, separate anatomical bundles of the ACL can be distinguished in 61.1% [22] of the specimens. The topographical alignment of the separate bundles is varied on a very wide range.

Arthroscopic management of superior labral anterior and posterior (SLAP) and associated lesions: clinical features and functional outcome.

INTRODUCTION: The superior labral anterior and posterior (SLAP) lesion is a cause of chronic shoulder pain and significant disability. This study aims to review the distribution of types of SLAP lesions, associated lesions and the outcome of arthroscopic management. MATERIALS AND METHODS: This series involved all 33 patients who underwent arthroscopic management of SLAP and associated lesions by a single surgeon. The pre- and postoperative disability scores were assessed using the disabilities of the arm, shoulder and hand (DASH) outcome measure. RESULTS: Type 2 SLAP lesion (64%) was the most common. Forty-eight per cent of the cases were associated with an ipsilateral shoulder lesion. A 10- point pre- and postoperative DASH score reduction was noted in 63% of the patients with isolated SLAP lesions and 73% of those with associated lesions. CONCLUSION: Arthroscopic management of the SLAP and its associated lesions results in improved functional outcome. The presence of associated lesions should be actively sought and managed in the same operative session.