Objective of the study

To determine if the location and pattern of knee pain as described by the patients using the knee pain map was comparable with the intra articular pathology found on arthroscopy as well as to facilitate diagnosis based on pain.

Study Design: Case Report

Purpose: To evaluate the role of using VEPTR™ to treat kyphosis in children with Hurler’s syndrome.

Summary of Background Data: Spinal manifestations are common in children with mucopolysaccridosis (MPS) and likely to increase with advances in bone marrow transplantation. However, no optimal treatment exists in treating kyphosis in children with MPS. VEPTR™ has not been previously used in children with MPS.

Methods: Evaluate the early results of one ambulating child with Hurlers syndrome who underwent treatment for their kyphosis using VEPTR™

Results: Early results at 7 months are excellent, despite an initial wound infection treated with dressing and antibiotics. No concerns arise with their gait and they have undergone their first lengthening. Excellent correction of their kyphosis has been achieved.

Conclusion: VEPTR™ offers an excellent implant in treating a selective group of children with MPS, who may have previously been declined surgery. To our knowledge this is the first case where this technique has been attempted on an ambulating MPS child.

Ethics Approval: None

Interest Statement: None

Purpose of Study: To study the anatomy of the accessory bands of Gracilis and Semitendinosus in order to avoid inadequate graft harvesting during ACL reconstruction.

Methods and Results: Data was collected from 25 arthroscopically performed ACL reconstructions using the hamstring tendons. For each patient the exact number of accessory insertion bands of the Gracilis and Semitendinosus was recorded, as well as the distance of the proximal most band from the main insertion point on the tibial crest.

Of the 25 Gracilis tendons, the most common number of accessory bands was 2, varying from 0 to 3. The average distance of the proximal most band was 5.14cm. The most common number of accessory bands for the Semitendinosus tendon was 3, varying from 1 to 4. The average distance of the proximal most band was 8.14cm. Five of the Semitendinosus and none of the Gracilis tendons had a proximal band located > 10cm. Average length and diameter of the four strand graft was 7.7cm and 13.2cm.

Conclusion: Gracilis and Semitendinosus tendons are increasingly being used for soft tissue reconstructions. Awareness of accessory bands of these tendons is essential in preventing diversion of the tendon stripper leading to a short and inadequate graft. Previous studies have shown that the anatomy of these bands is highly varied. Such cadaveric studies have shown a high percentage of tendons with bands > 10cm proximal to their insertion [2]. Our study shows that 20% of Semitendinosus and none of the Gracilis tendons had bands more than 10cm proximal to their insertion. Gaining knowledge about accessory insertion bands of the hamstrings should assist reproducible and adequate graft harvest.