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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 342 - 342
1 Jul 2011
Nikolopoulos D Apostolopoulos A Nakos A Vasilas S Drabalos S Barbounakis N Michos J
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To compare the early functional and clinical results, between single (SB) and double-bundle (DB) of Anterior Cruciate Ligament (ACL) reconstruction with hamstrings (HS).

Thirty-six patients from 17 to 36 years old (average age 23), 22 ♂ and 14 ♀, from January 2006 to May 2008, were randomly allocated for ACL reconstruction with HS (SB – DB). Eighteen patients underwent a 4-stranded SB reconstruction (group A) and the remaining 18 underwent an anatomic, 2-stranded DB ACL reconstruction with 2 tibial and 2 femoral tunnel technique (group B), by using the Smith & Nephew instrumentation system. The follow-up was from 8 to 22 months (average 16 months) for both groups and included clinical evaluation (pivot-shift test, anterior laxity test with KT-1000 arthrometer and Lysholm knee score) and radiographs.

There were no statistically significant difference in the results between the 2 groups with regard to the pivot-shift test and the Lysholm score (SB: mean 91, DB: mean 89) (Mann-Whitney test, T-test). The anterior laxity was not significantly different between group A (mean, 2.2mm) and group B (mean, 0.9mm), according to KT-1000 measurements. Rotational stability, as evaluated by pivot-shift test, was better in group B than in group A, but statistical analysis showed no significant difference. The average operation time was longer in DB (110 min) compared to SB (80 min). There were no infections, though one patient of each group was found to be complicated with fixed flexion and extension lag > 5°; and underwent arthroscopic lysis.

Our study shows no statistically significant advantage of DB versus SB ACL reconstruction, concerning the clinical evaluations and the complications


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 67 - 68
1 Mar 2006
Rallis I Rallis J Mellios J Doussias A Aggoules AF Lytos M Michos J
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Purpose: To assess the extended trochanteric osteotomy approach, used for revision of hip replacement.

Material – Methods: Between January 1998 and December 2002, sixteen (16) hip replacement revision procedures were performed on 16 patients, (10 male, 6 female), with extended trochanteric osteotomy approach. Average age was 67 years (52–79).

Nine (9) procedures involved the femoral stem only, and seven (7) both components. Six (6) stems were fixed with cement and ten (10) without.

In all cementless cases, fixation of the stem in the medullary canal was achieved for at least 4 cm below the osteotomy level. The length of the stem beyond the osteotomy was three times the width of the canal.

The length of the osteotomy varied from 12 to 18 cm (av. 14 cm), and the length of the inserted components ranged from 210 – 280 mm (av.225 mm).

Results: Union of the osteotomy was achieved in all cases from 4 – 9 months (av 5.5). There was no intra-operative or postoperative fracture. No dislocation or infection was recorded. Two prostheses presented sinkage of 1 and 1.5 cm respectively. So far no patient has been reoperated in the revised hip.

Conclusions: The extended trochanteric osteotomy approach for hip replacement revision, offers excellent view of the femoral canal and facilitates the removal of the prosthesis, while the complications due to approach are minimal.