Augmented short undersized hamstring tendon graft with LARS® artificial ligament versus four-strand hamstring tendon in anterior cruciate ligament reconstruction: preliminary results.

BACKGROUND: This retrospective study compares the results of reconstruction of isolated chronic anterior cruciate ligament rupture using augmented short undersized sized hamstring tendon graft with ligament advanced artificial reinforcement system (LARS) versus a four-strand hamstring tendon graft (4-SHG). Our hypothesis was that postoperative knee stability after using augmented short length or small diameter hamstring tendon graft with LARS artificial ligament could be significant and satisfactory more than 4-strand hamstring tendon graft group. MATERIALS AND METHODS: Between June 2007-July 2008, 72 patients were divided into a (LARS) augmented group (n=27) and a (4-SHG) group (n=45). RESULTS: Mean FU is 5years. KT-1000 examinations showed that the LARS group had significantly less anterior displacement than the (4-SHG) group P=0.013. IKDC score demonstrated statistically significant differences (P=0.05). CONCLUSIONS: Our study indicates that early results of augmenting: short length or small diameter harvested hamstring tendons with LARS in ACL reconstruction provides satisfactory, comparable results and displayed higher knee stability compared to (4-SHG) group. LEVEL OF EVIDENCE: Level III (case control study).

[Shoulder resurfacing in patients with rotator cuff arthropathy and remaining subscapularis function]. / Oberflächenersatz bei Rotatorenmanschettendefektarthropathie mit erhaltener Subscapularisfunktion.

INTRODUCTION: Glenohumeral arthritis with a massive rotator cuff tear is a devastating condition that seriously compromises the comfort and function of the shoulder. Cuff tear arthropathy presents a unique surgical challenge and many arthroplasty options were used for its treatment. The purpose of this study was to evaluate the clinical and radiological results of Copeland cementless surface replacement arthroplasty (CSRA) applied in patients with cuff tear arthropathy and intact subscapularis function. PATIENTS AND METHODS: The study was conducted on twenty-five shoulders in twenty-five patients with cuff tear arthropathy with the subscapularis tendon still intact. The patients were prospectively followed-up clinically and radiologically for a mean of 26 months (range: 15 - 38 months). There were 16 female and 9 male patients. The mean age was 69.04 years (range: 53 - 83 years). The mean operative time was 38 minutes (range: 28 - 56 minutes). The clinical assessment was performed with the Constant score. RESULTS: The Constant score significantly improved from a mean of 14.04 points preoperatively to 53.17 points postoperatively. Of the patients, 88 % considered the shoulder to be much better or better as a result of the operation. Radiologically, the humeral offset, the lateral glenohumeral offset (coracoid base to the greater tuberosity), height of centre of instant rotation and the acromiohumeral distance were significantly increased. No intra- or postoperative complications were encountered. CONCLUSION: Our early results with the use of Copeland surface replacement in selected cases with cuff tear arthropathy are encouraging. The patients showed significant clinical (pain and range of motion) and radiological improvements. Moreover, if the surface replacement were to fail for any reason, it can be revised to a reverse prosthesis type as there is no lack of bone stock.