Despite the myriad new spinal instrumentation systems, scoliosis can rarely be fully corrected, especially when the curves are stiff. A novel superelastic nickel-titanium (nitinol) rod that maximises the ability to slowly correct spinal deformities by utilising the viscoelastic properties of the spine has been developed. This parallel, double-blinded, randomised controlled trial compared the safety and efficacy of these new rods to conventional titanium rods in 23 patients with adolescent idiopathic scoliosis. The superelastic nitinol rods were found to be safe, could gradually correct scoliosis curves, and ultimately resulted in better coronal and sagittal alignments compared to traditional rods.

Despite the myriad new spinal instrumentation systems, scoliosis can rarely be fully corrected, especially when the curves are stiff. A novel superelastic nickel-titanium (nitinol) rod that maximises the ability to slowly correct spinal deformities by utilising the viscoelastic properties of the spine has been developed. This parallel, double-blinded, randomised controlled trial compared the safety and efficacy of these new rods to conventional titanium rods in 23 patients with adolescent idiopathic scoliosis. The superelastic nitinol rods were found to be safe, could gradually correct scoliosis curves, and ultimately resulted in better coronal and sagittal alignments compared to traditional rods.

The purpose of this study is to investigate the incidence of patients with isolated bundle ACL tear (either isolated posterolateral or anteromedial bundle) during arthroscopy, and its correlation with physical exam. The relevant surgical technique to reconstruct the ligament is discussed.

Between September 2006 and March 2009, patients with ACL injuries who received double- bundle ACL reconstruction were reviewed retrospectively. A specialist fellow performed a physical exam before and after anaesthesia. Intraop status of the ACL tear was assessed with correlation of the physical findings. Patients with isolated bundle tear would receive anatomical reconstruction of the torn bundle with preservation of the intact bundle.

Double-bundle hamstrings reconstruction would be performed to those with complete tear. Medical notes of 159 patients were reviewed. There were 118 patients (74%) with complete ACL tear, 36 (23%) with isolated AM tear, and 5 (3%) with PL tear.

For patients with complete ACL tear, 94% and 100% had positive Lachman, 50% and 87% had positive pivot shift, before and after anaesthesia. For patients with isolated AM tear, 100% had positive Lachman, 36% and 19% had positive pivot shift, before and after anaesthesia.

For patients with isolated PL tear, 100% had positive Lachman, 20% and 80% had positive pivot shift, before and after anaesthesia.

With better understanding of ACL, patients with isolated-bundle tear can preserve their intact bundle during reconstruction. However, in this study we find that physical exam correlates poorly with the arthroscopic findings.

Further imaging (e.g. MRI) may be helpful to differentiate patients from isolated- bundle tear to complete tear.