Tunnel widening after single- versus double-bundle anterior cruciate ligament reconstruction: a randomized 8-year follow-up study.

OBJECTIVE: The purpose of this study was to compare the single-bundle (SB) and double-bundle (DB) surgical techniques for anterior cruciate ligament (ACL) reconstruction with regard to tunnel widening, isokinetic muscle strength, and clinical outcomes over an 8-year follow-up period. METHODS: This study included 31 patients with ACL injury who underwent ACL reconstruction via the SB (n = 16) or the DB (n = 15) technique. Isokinetic and concentric strength measurements of the quadriceps and hamstring muscles were conducted at postoperative 6 months and postoperative 8 years, and 3D-CT scans of the knee joints were performed on the 2nd, 3rd and 6th month, and the 8th year postoperatively. Clinical evaluations were performed at 8 years postoperatively with the International Knee Documentation Committee (IKDC), Tegner, and Lysholm knee scoring systems. RESULTS: There was marked widening of the parts of the femoral tunnel close to the knee joint in both the SD and the DB groups. There was no difference between the two groups in terms of clinical results and isometric muscle strength at postoperative 8 years; however, there was a significant difference between the preoperative and 6 months postoperative clinical and strength results in both group (P < 0.05). There was no difference between the groups in IKDC score, Lysholm score, Tegner activity scale, and anterior drawer test at postoperative 8 years. On evaluation of the anteromedial bundles alone, the DB group had greater widening than the SB group. CONCLUSION: In this study, we have found that the tunnels continue to enlarge after 6 months. However, that has no impact in patients comfort and that did not made any change in our daily routine. On the other hand, we found that the reconstruction of the double-band ligament technique is useless for non-professional athletes.

Thermally induced shape memory behavior, enzymatic degradation and biocompatibility of PLA/TPU blends: "Effects of compatibilization".

Poly(lactic acid) (PLA)/thermoplastic polyurethane (TPU) blends were melt-mixed and compatibilized to investigate their biocompatibility, biodegradability and thermally induced shape memory properties. The blend compositions were PLA/TPU: 80/20 (20TPU) and PLA/TPU: 50/50 (50TPU). 1,4-phenylene diisocyanate (PDI) was used in order to compatibilize the components reactively. The PDI composition was 0.5, 1, 3% by weight. Biodegradability was assessed by enzymatic degradation tests. Biocompatibility was investigated through in-vitro cell-culture experiments. Shape memory tests exhibited that 20TPU blends have higher recovery ratio than that of 50TPU blends. It was observed that the shape recovery ratio was enhanced by the addition of PDI. The highest shape recovery ratio was obtained at 3%PDI in 20TPU blends. Enzymatic biodegradability tests showed that the increasing TPU content decreased the biodegradability of the blends. It was found that compatibilization slowed down the enzymatic degradation of PLA/TPU blends. In-vitro cell-culture experiments indicated that all blends were biocompatible, and no evidence of cytotoxicity was observed.

MRI manifestations of soft-tissue haemangiomas and accompanying reactive bone changes.

OBJECTIVES: Soft tissue haemangiomas are common benign vascular lesions that can be accompanied by reactive changes in the adjacent bone structure. This study aimed to discuss the MRI features of soft-tissue haemangiomas with an emphasis on changes in bone. METHODS: The radiographic and MRI findings of 23 patients (9 males, 14 females; mean age 25 years; age range 2-46 years) with soft-tissue haemangiomas were analysed retrospectively. MR images were evaluated for location of the lesion, size, configuration, signal features, contrast patterns, proximity to adjacent bone and changes in the accompanying bone. Excisional biopsy was performed in 15 patients. RESULTS: Radiographs demonstrated phleboliths in 8 patients (34%) and reactive bone changes in 4 (19%). On MRI, T1 weighted images showed that most of the lesions were isointense or isohyperintense, as compared with muscle tissue; however, on T2 weighted images all lesions appeared as hyperintense. Following intravenous gadolinium-diethylene triamine pentaacetic acid (DTPA) administration, homogeneous enhancement was observed in 3 lesions and heterogeneous enhancement was seen in 19. No enhancement was observed in one patient. Bone atrophy adjacent to the lesion was observed in four patients. CONCLUSION: MRI is the most valuable means of diagnosing deep soft-tissue haemangiomas. Bone changes can accompany deeply situated haemangiomas; in four of our patients, we found atrophy of the bone adjacent to the lesion. To our knowledge, this is the first report in the literature regarding atrophy of the bone adjacent to a lesion.