The American journal of sports medicine
-
Revision open Bankart surgery after arthroscopic repair for traumatic anterior shoulder instability.
Only a few studies have provided homogeneous analysis of open revision surgery after a failed arthroscopic Bankart procedure. ⋯ Open revision Bankart surgery for a failed arthroscopic Bankart repair can provide a satisfactory outcome, including a low recurrence rate and reliable functional return. In open revision Bankart surgery after failed stabilization for traumatic anterior shoulder instability, the surgeon should keep in mind the possibility of a postoperative loss of range of motion and a thorough examination for not only a Bankart lesion but also other associated lesions, including a bone defect or hyperlaxity, to lower the risk of redislocation.
-
Meniscal allograft transplantation is an accepted treatment for the symptomatic postmeniscectomized knee in younger patients; however, long-term data are scarce on clinical outcome. ⋯ Long-term follow-up results show that meniscal allograft transplantation is a beneficial procedure. Good improvements in clinical function and pain relief have been shown at short-term follow-up in this population. Despite the deterioration in function scores over time, there is still improvement in level of function at long-term follow-up but not at a high level. As such, meniscal allograft transplantation is a good salvage option for the treatment of degenerative arthritis of the symptomatic post-meniscectomized knee. Meniscal allograft transplantation can be used to postpone total knee arthroplasty in younger patients.
-
Determination of appropriate treatment options for adult osteochondritis dissecans is difficult, as most published papers on surgical osteochondritis dissecans treatment report outcomes in a population consisting of both adult and juvenile patients. ⋯ Patients with adult osteochondritis dissecans of the knee, treated with surgical cartilage procedures, show durable function and symptomatic improvement at a mean 4.0 years of follow-up. Patients treated with arthroscopic reduction and internal fixation and loose-body removal demonstrated a greater improvement in outcome scores than those treated with osteochondral allograft.
-
Randomized Controlled Trial Comparative Study
Patellar tendon versus hamstring tendon autografts for anterior cruciate ligament reconstruction: a randomized controlled trial using similar femoral and tibial fixation methods.
Controversy remains over the most appropriate graft for anterior cruciate ligament reconstruction. ⋯ Hamstring and patellar tendon autografts provide similar objective, subjective, and functional outcomes when assessed at least 2 years after anterior cruciate ligament reconstruction.
-
Despite the popularity of microfracture as a first-line treatment for articular cartilage defects in the knee, systematic information on its clinical efficacy for articular cartilage repair and long-term improvement of knee function is not available. ⋯ This systematic analysis shows that microfracture provides effective short-term functional improvement of knee function but insufficient data are available on its long-term results. Shortcomings of the technique include limited hyaline repair tissue, variable repair cartilage volume, and possible functional deterioration. The quality of the currently available data on micro-fracture is still limited by the variability of results and study designs. Further well-designed studies are needed to determine the long-term efficacy of microfracture and to define its specific clinical indications compared to other cartilage repair techniques.