The American journal of sports medicine
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Randomized Controlled Trial
Quality of life and clinical outcome comparison of semitendinosus and gracilis tendon versus patellar tendon autografts for anterior cruciate ligament reconstruction: an 11-year follow-up of a randomized controlled trial.
There are still controversies about graft selection for primary anterior cruciate ligament reconstruction. Prospective, randomized long-term studies are needed to determine the differences between the graft materials. ⋯ Both hamstring and patellar tendon autografts provided good subjective outcomes and objective stability at 11 years. Positive pivot-shift test (1+) was significantly more frequent in the PT group. No significant differences in the rate of graft failure were identified. Patients with patellar tendon graft had a greater prevalence of osteoarthritis at 11 years after surgery.
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Comparative Study
Functional and structural outcomes of single-row versus double-row versus combined double-row and suture-bridge repair for rotator cuff tears.
Although previous biomechanical research has demonstrated the superiority of the suture-bridge rotator cuff repair over double-row repair from a mechanical point of view, no articles have described the structural and functional outcomes of this type of procedure. ⋯ The additional suture bridges decreased the retear rate for large and massive tears. The combination of the double-row and suture-bridge techniques, which had the lowest rate of postoperative retear, is an effective option for arthroscopic repair of the rotator cuff tendons because the postoperative functional outcome in patients with a retear is inferior to that without retear.
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Comparative Study
Biomechanical comparison of arthroscopic repairs for acromioclavicular joint instability: suture button systems without biological augmentation.
Arthroscopic procedures for reconstruction of acromioclavicular (AC) joint separations are increasingly used in clinical practice. Multiple surgical techniques exist, but there are still few data on biomechanical performances of commonly used arthroscopic techniques and fixation methods. ⋯ Single clavicular tunnel arthroscopic reconstructions of the coracoacromial ligaments show good biomechanical results.
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Suture bridge repair has been recognized to have superior biomechanical characteristics, as shown in previous biomechanical studies. However, it is not clear whether the tendon heals better in vivo after suture bridge repair. ⋯ Arthroscopic suture bridge repair of full-thickness rotator cuff tears led to a relatively high rate of recurrent defects. However, the mean 25-month follow-up demonstrated excellent pain relief and improvement in the ability to perform the activities of daily living, despite the structural failures. The factors affecting tendon healing were the patient's age, the size and extent of the tear, and the presence of fatty degeneration in the rotator cuff muscle. The retear in cases with a suture bridge technique tended to be more frequently at the musculotendinous junction.
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Comparative Study
Comparison of different fixation methods of the suture-button implant for tibiofibular syndesmosis injuries.
Suture-button fixation for tibiofibular syndesmosis injuries is a relatively new surgical technique thought to provide semirigid dynamic stabilization. However, adequate information is still not available and there are controversies as to whether it provides enough fixation for syndesmosis injuries. ⋯ Optimal direction of the suture button can provide adequate stabilization of the ankle and could benefit athletes with syndesmosis injuries.