Introduction. Anterior cruciate ligament (ACL) reconstructive surgery is one of the most commonly performed surgical procedures. Synthetic
We studied the efficacy of arthroscopic
Autologous chondrocyte implantation (ACI) is contra-indicated in a joint rendered unstable by a ruptured anterior cruciate ligament (ACL). We present our experience of ACI repair with ACL reconstruction Patients underwent arthroscopic examination and cartilage harvesting of the knee. A second operation was undertaken approximately six weeks later to repair the ruptured ACL with hamstring graft or Bone patella-Bone (BPB) and to implant the chondrocytes via formal arthrotomy. Three groups were assessed: Group 1: Simultaneous ACL Reconstruction and ACI; Group 2: Previous ACL Reconstruction with subsequent ACI repair; Group 3: Previously proven partial or complete ACL rupture, deemed stable and not treated with reconstruction with ACI procedure subsequently. Patients then underwent a graduated rehabilitation program and were reviewed using three functional measurements: Bentley functional scale, the modified Cincinnati rating system, and pain measured on a visual analogue scale. All patients also underwent formal clinical examination at review.Introduction
Methods
The management of medial osteoarthritis of the knee with underlying anterior cruciate ligament deficiency is challenging. Stabilization of the ligament instability at the time of re-alignment osteotomy addresses both components of the disability. We are reporting a retrospective study of thirty-two cases of combined osteotomy and ligament repair between 1995 and 2000. Patients were assessed by questionnaire and clinical examination. Objective measures, using the modified Lystolm score, WOMAC index and SF36 were performed. Radiological examination as well as a survivor-ship analysis were performed. The average age at operation was thirty-six with an average follow-up of five years. Surgery was performed in patients who had complaints of both pain and instability and also had objective findings of Uni-compartmental osteoarthritis and anterior cruciate deficiency. Seventy five percent of patients were classed as good to excellent with only five percent of patients classed as poor. Combined tibial osteotomy and anterior cruciate reconstruction is an effective means to deal with this complex problem.
The purpose of this study was to report the experience of dynamic
intraligamentary stabilisation (DIS) using the Ligamys device for
the treatment of acute ruptures of the anterior cruciate ligament
(ACL). Between March 2011 and April 2012, 50 patients (34 men and 16
women) with an acute rupture of the ACL underwent primary repair
using this device. The mean age of the patients was 30 years (18
to 50). Patients were evaluated for laxity, stability, range of
movement (ROM), Tegner, Lysholm, International Knee Documentation Committee
(IKDC) and visual analogue scale (VAS) scores over a follow-up period
of two years.Aims
Patients and Methods
Surgical marking during tendon surgery is often used for technical
and teaching purposes. This study investigates the effect of a gentian
violet ink marker pen, a common surgical marker, on the viability
of the tissue and cells of tendon.
Objectives
Methods
Excessive postoperative opioid prescribing is a significant contributor to the opioid crisis. Prescribing in orthopaedic surgery is often further complicated by high use of opioid-based preoperative analgesia. ‘Opioid PrEscRiptions and usage After Surgery’ (OPERAS) is an international multicentre prospective student- and trainee-led collaborative study which aims to quantify the amount of opioids prescribed at discharge after common orthopaedic surgeries against what is consumed by patients at 7-days, and assess the impact of opioids on patient-reported outcomes. Data is being collected over 6 14-day periods on consecutive adult patients undergoing shoulder arthroplasty, rotator cuff repair, shoulder labral repair,
Injury to the anterior cruciate ligament (ACL)
is one of the most devastating and frequent injuries of the knee. Surgical
reconstruction is the current standard of care for treatment of
ACL injuries in active patients. The widespread adoption of ACL
reconstruction over primary repair was based on early perception
of the limited healing capacity of the ACL. Although the majority
of ACL reconstruction surgeries successfully restore gross joint stability,
post-traumatic osteoarthritis is commonplace following these injuries,
even with ACL reconstruction. The development of new techniques
to limit the long-term clinical sequelae associated with ACL reconstruction
has been the main focus of research over the past decades. The improved
knowledge of healing, along with recent advances in tissue engineering
and regenerative medicine, has resulted in the discovery of novel
biologically augmented ACL-repair techniques that have satisfactory
outcomes in preclinical studies. This instructional review provides
a summary of the latest advances made in
Introduction: recent studies showed the possibility of spontaneous ACL healing in acute lesion with proper treatment. The goal of our study was to analyze the functional outcome of partial ACL tears treated acutely with suture-repair combined with a bone marrow stimulation (BMS) technique (microperforation). We hypothesized that knee stability could be restored and good functional outcome could be obtained with a simple primary repair technique. Methods: From January 2003 to January 2006, 22 patients (14 males and 8 females – mean age: 23 years) with partial ACL rupture underwent acute primary
An important aspect of the governance of surgical services within a Healthcare Trust is the correct coding of elective procedures performed. Within the Trust, treatment codes are banded into specific healthcare resource groups (HRGs), which generate a predetermined income. Accurate coding and grouping of the treatments provided for patients is consequently vital to Trusts to ensure that they receive appropriate financial reward for the care provided, so ensuring they remain economically viable as a department. We present a retrospective study investigating the accuracy of procedure coding, code allocation to HRGs, and the resultant cost consequences for all elective arthroscopic anterior cruciate ligament (ACL) repairs completed by one consultant over one financial year (01/01/2010-31/03/2011). In this period a total of 55
Purpose: Anterior cruciate ligament (ACL) repair is increasingly performed to allow athletes reach their earlier sports performance or higher, leading to the risk of repeated tears. Several grafts can be proposed: the contralateral patellar ligament, hamstring tendons and the rectus femoris tendon. The purpose of this study was to analyse results in a continuous series of repeated tears of the
The December 2022 Sports Roundup360 looks at: Anterior cruciate ligament (ACL) repair with dynamic intraligamentary stabilization or anterior ACL at five years?; Femoroacetabular impingement in mild osteoarthritis: is hip arthroscopy the answer?; Steroids in Achilles tendinopathy: A randomized trial.
Computer assisted navigation is known to improve tunnel placement in ACL reconstruction even compared to use of direct arthroscopic view due to image distorsion by the wide angle optics in the arthroscope. However the earlier software and instrumentation has been relatively cumbersome. The use of new materials and further software elaboration has allowed to increase the navigational precision and to accommodate more different
In an animal model we determined the strength of anterior cruciate ligaments (ACL) after section and repair by four different methods and compared it with that of the intact ligament. The standard suturing technique of multiple loops through the ligament stumps was used. Stronger suture material did not give a stronger repair. Wrapping a fine polyester mesh around the ligament or placing it between the bundles before suture increased the strength of the repair. This modification, allied to protective rehabilitation, may reduce the failure rate of acute
Previous Anterior Cruciate Ligament (ACL) reconstruction is currently a bar from entry to the Royal Marines and Royal Navy, whilst the British Army allows recruits to join if asymptomatic 18 months post ACL reconstruction. However current Royal Marines policy is to rehabilitate recruits who sustain an ACL disruption in training. We retrospectively analysed the rehabilitation times and pass out rate of Royal Marines who had an ACL disruption during recruit training over an 8 year period. 12 recruits sustained an ACL disruption during recruit training in the study period, giving an incidence of around 1.5/1000 recruits. 9 Patients underwent
INTRODUCTION. Patellar tendon (PT) autograft is an excellent choice repairing anterior cruciate ligament (ACL) ruptures. Published studies testing the biomechanical characteristics after plasty usually refer to grafts with 10mm wide. The thickness of PT and geometry of the patella have been overlooked. The purpose of this study was to understand the geometry of PT and patella in our population, regarding their use in Bone - Patellar Tendon - Bone (BTB) technique, in order to evaluate their biomechanical efficiency and study their relationship with anthropometric parameters. MATERIAL. 100 individuals (50/50) who underwent knee MRI (3-Tesla). Ages between 18–65years. METHODS. Retrospective study. Standardized protocol for measuring the PT and patella based in MRI images. Interview to obtain personal data. Statistical analysis using SPSS®. RESULTS. Sample (mean ±SD): age 41 ±14years, weight 73 ±12kg, height 167 ±10cm, BMI 26,04 ±4,13; length PT/patella −41,3 ±6,1mm/29,6 ±4,2 mm, width PT/patella −25,3 ±3,2mm/43,4 ±4,14mm; thickness PT −3,79 ±1,01mm/22,8 ±2,2mm; Men have thicker and wider patella and PT than women (p<0.001). The patella is also longer in males (p<0.001). There is statistical significant relationship between weight and height to width, thickness and length of PT and patella (p<0.01). Body Mass Index (BMI) doesn't have statistical correlation with geometry of the PT and patella. DISCUSSION. The PT remains as an excellent option in