Aims: To evaluate the morphologic changes in the patellar tendon 10 years after harvesting its central third for reconstruction of the anterior cruciate ligament, and examine the association between the morphologic changes and the occurrence of anterior knee pain of the patients. Methods: Thirty-one patients who had undergone an anterior cruciate ligament reconstruction using central-third bone-patellar tendon-bone autograft with a closure of the patellar tendon defect were included in this study. An ultrasonographic and Power Doppler examination was performed at a mean follow-up of 10 years. Results: Ultrasonography of the harvested patellar tendon showed intratendinous calcification in 9 patients, hypoechoic lesion in 20 patients, hyperechoic lesion in one patient, and peritendinous changes in one patient. No abnormality was visible in the contralateral (normal) patellar tendons of the 31 patients. The harvested patellar tendon was significantly thicker than the contralateral patellar tendon both at the proximal third (p=0.017) and at the distal third (p=0.020) of the tendon. Patellar osteophytes were more common in patients with anterior knee pain than without it (p=0.05). Conclusions: Sonographic morphologic changes of the patellar tendon were common 10 years after the harvesting procedure. Also, the harvested patellar tendon was significantly thicker than the normal patellar tendon.

Aims: To evaluate the outcome of surgery in patients with lumbar spine degenerative disease or isthmic spon-dylolisthesis. Methods: Lumbar spine fusion with or without decompression was performed in 132 consecutive patients. Altogether 115 patients attended to follow-up an average 3.4 years after operation. The overall result was assessed by the patient and by an independent observer. Moreover, the disability was measured using Oswestry questionnaire and fusion rate was assessed from flexion and extension radiographs. Results: The complications of surgery were: misplacement of screws in 2 patients, paresis of peroneal nerve in 1 patient, superficial wound infection in 4 patients, breakage of fixation device in 1 patient and spinal fluid fistulas in 2 patients. According to patient’s own opinion the result of surgery was excellent, good or fair in 86 percent of the patients and even 89.6% of them benefited from the surgery. The average postoperative Oswestry score was 28. According to radiographs the fusion rate was 93 percent. At the time of operation 40 patients were retaired and 66 (93%) out of the 75 patients who were still at working age returned to work. Conclusion: Lumbar spine fusion is an effective and safe treatment of degenerative lumbar spine disease and isthmic spondylolisthesis. However, the careful selection of patients is an important factor for success.