The assessment of graft stability in ACL reconstruction with two different techniques (endobutton vs. crosspin) and the comparative evaluation of the results of the two techniques.

From October 2005 until May 2009, 69 patients underwent ACL reconstruction with the above-mentioned techniques by two surgeons; follow-up examinations took place after a minimum of two (2) years. Postoperative radiographic and clinical assessment were carried out and Lysholm, Tenger and IKDC scores were obtained at 3, 6, 12 and 24 months; stability was checked by KT-1000 arthrometer. Clinical evaluation by Lachman and pivot shift was normal or near-normal in 65 patients. No significant differences were found both as regards the KT-1000 (1.0 mm less with the cross-pin technique) and as regards the subjective variables (the endobutton having a slight advantage). Mean postoperative IKDC evaluation was 87.4 vs. 85.3, while Lysholm was 89 vs. 86. Two patients underwent revision after a new traumatic incidence and one displayed a new meniscal lesion, which was treated accordingly. The vast majority of the patients returned to their previous occupational activities and social life (overall patient satisfaction was at 88.2 vs. 85.4).

Both the endobutton and the crosspin techniques proved to be reliable fixation methods for the treatment of ACL ruptures using the hamstrigs tendons; both methods provided safe fixation even in cases when back wall blow had occurred

The assessment of the arthroscopic findings in patients suffering from impingement syndrome and partial tear of the supraspinatus tendon, staged as type 1& 2 under Ellman, Gartsman, Snyder, that were treated by acromioplasty, debridment and repair of the supraspinatus tear.

Thirty four patients,(20 male, 14 female), with a median age of 52 years, (48–64 years old), underwent shoulder joint arthroscopy. All were evaluated by two physicians and subjected to plain films (AP& Y views) as well as to MRI.

Clinically, the differencies in the evaluation of patients with type 1& 2a lesion were insignificant. Type 2b had a better outcome, but in comparison to type 1, that were subjected only to acromioplasty, variations involving range of motion, pain and scoring (Constant & Oxford scores), were observed, from the first stages of rehabilitation, with no further improvement. The comparative method in relation to the clinical trials was in favor of those patients treated with repair of the tear.

After a 29 m follow up, we suggest only acromioplasty, in stages 1& 2a, although the daily activities of each patient can change the approach. In type 2b lesions, irrespective of age, we suggest the repair of the tear

The assessment of the long –term outcome (5 years) of patients treated with arthroscopic stabilization for acute traumatic patellar dislocation.

From September 2004 until April 2009 we treated 29 patients (25 male, 4 female) with a median age of 18 years (range 14–23 years), two of them had suffered from traumatic dislocation of the patella of the other knee joint in the past. The median range from injury to our surgical intervention was 20 days (7–29 days). The return in sporting activities, the possible redislocation or joint instability and the subjective assessment of the symptoms of the patients, were evaluated in a 5 years follow-up. After 5 years, 23 patients (20 males, 3 females), were re-evaluated.

After the arthroscopic medial retinacular repair all the patients return to sporting activities. All the patients presented chondral lesions at the medial facet of the patella and to the lateral femoral condyle and hemarthrosis too. The functional outcomes were evaluated with Kujala scoring scale, with Visual analog scale and Tenger scale the range of results was good.

The acute arthroscopic repair of the medial retinacular ligaments, protects the patient from redislocation or subluxation, allows the evaluation and stabilisation of the chondral lesions, the removal of free chondral bodies, as well as the evaluation of the possible damage to the menisci or ACL, PCL ligaments.

All the patients returned to normal sporting activity avoiding further injury, or the development of osteoarthritis of the knee joint

Aim of the study : The purpose of this work was to study the short term results of the surgical treatment of subtrochanteric femoral fractures with the use of long gamma nail.

Material – method : Fifteen consecutive patients suffering from subtrochanteric fracture of their femur, were treated by means of long gamma nail in our clinic during the last two years. The type of fracture concluded comminuted subtrochanteric fractures, unstable spiral fractures and fractures on previous operated on peritrochanteric fractures.

Results : The patient’s age averaged the 76 years. There were 4 men and 11 women. The follow-up period was from 5 months to 2 years. The blood transfusion averaged the 2 units. All patients ambulated the second postoperative day and the fracture healing observed two months later. We have no infection, pseudarthrosis or hardware failure at this series.

Conclusion : Long gamma nail is a method of choice in the treatment of subtrochanteric femoral fractures. We can achieve stable osteosynthesis, without soft tissue damage and immediate ambulating of the patient.