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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_III | Pages 246 - 246
1 Mar 2004
Springer J Mastrokalos D Kilger R Paessler H
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Aim: Goal of this prospective, randomized study is the functional evaluation of two different techniques of ACL reconstruction by using bone-patellatendon (BPT) vs. hamstrings (ST/G). Methods: 62 ACL-insufficient patients (33 women/29 men) took part in this study. 31 (mean:29,8 y.) underwent ACL-reconstruction using BPT (GI). 31 (mean: 34,2 y.) patients underwent ACL-reconstruction using ST/G (GII). Both techniques were press-fit and implant-free. We used accelerated rehabilitation for both groups. Patients were evaluated by IKDC, Lysholm and Tegner score, KT 1000, one-leg-hop, isokinetics, internal torque, kneeling- and knee-walking-test, 1 day preop., and 3, 6 and 12 months postop. Results: One year results of GII were according to IKDC-score (GII: 30 patients= A and B vs. GI: 24 patients= A and B), Lysholm-score (GII: 95,61 vs. GI: 90,87 (p=0.017) and Tegner-score (GII: 7,07 vs. GI: 6,61 (p=0.00)) better than those of GI. The Evaluation of the strength of hamstrings using isokinetics showed significant differences: GII: 90,34 Nm vs. 99,19 Nm in GI, (p=0.008). However results concerning the internal torque evaluation were not significant. The one-leg-hop comparing injured and non-injured leg resulted in significant differences: GII: 96% vs. GI: 91%, (p=0.012). Results in GI were significantly worse than in GII at kneelling and kneewalking-testings ((p=0.00)(p=0.00)). Conclusion: All scoring, clinical and functional evaluations, except isokinetic hamstring evaluation, showed a hamstring’s supperiority in ACL reconstruction.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 181 - 181
1 Feb 2004
Kotsovolos I Mastrokalos D Kilger R Thermann H Paessler H
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Aim: Our aim was to evaluate the accuracy and reliability of both MRI and CT in estimating the patello-femoral alignement with the TT/TG (tibial tuberosity/trochlear groove) distance in 14 healthy probants.

Method: The TT/TG distance has been estimated in 28 healthy knees of 14 probants, 8 women and 6 men (age: 24 – 42) with a) MRI in an Esaote Arthroscan 0,2 Tesla Tomographer and b) CT in a General Electric Tomographer. This parameter was estimated in both imaging devices, first by overprojecting a tibial axial image through the tibial tuberosity onto an axial image through both femoral condyles and then by measuring the distance between the deepest point of the trochlear groove and the most prominent point of the TT. The parameter has been estimated twice by 3 well trained independent observers. The statistical evaluation was done with an unifactorial analysis of variance (ANOVA).

Results: Our results showed a good reproducibility (> 95%) of the TT/TG measurement in both methods: The intraobserver reliability was in CT, 0,008 ± 0,005mm and in MRI 0,03 ± 0,0017mm respectively. The interob-server reliability was 0,046 for the CT and 0,66 for the MRI. Interesting was that the average value of TT/TG by measuring with MRI (14 mm) was 3 mm less than the one measured with CT (17mm).

Conclusion: We concluded that in spite of the difference of the average values between MRI and CT the evaluation of the TT/TG parameter by means of MRI could be a good method for estimating this parameter thus avoiding radiation uptake.