Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2010
Case ReportsIntraosseous foreign body granuloma in rotator cuff repair with bioabsorbable suture anchor.
Biodegradable implants lead to problems such as cyst formation, soft-tissue inflammation, loose implant fragments or local osteolysis. This report represents the first published case of an intraosseous foreign body granuloma in the humeral head after arthroscopic rotator cuff tear fixation with a poly-L: -lactide (PLLA) suture anchor. A 48-year-old female patient presented with pain in her right shoulder. ⋯ Foreign body granulomas are a well known but rarely described complication that arises after the use of biodegradable suture anchors in shoulder surgery. Every patient presenting with shoulder pain after usage of a biodegradable fixation material should be evaluated closely. Orthopaedic surgeons should be aware of the possibility of delayed foreign body reactions, especially after using PLLA anchors.
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Arch Orthop Trauma Surg · Aug 2010
Double-bundle reconstruction cannot restore intact knee kinematics in the ACL/LCL-deficient knee.
The aim of this study was to evaluate the effect of single-bundle (SB) and anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction on the resulting knee kinematics in a simulated clinical setting with ACL rupture and associated extra-articular damage to the lateral structures. It was hypothesized that anatomic DB ACL reconstruction restores the intact knee kinematics in ACL/LCL-deficient knees, whereas SB ACL reconstruction fails to restore the intact knee kinematics. ⋯ The results of the study did not support our initial hypothesis. Though DB reconstructions were significantly superior to SB reconstruction under simulated KT 1000 test, SB as well as DB reconstruction failed to restore the intact kinematics under simulated pivot shift loads. The clinical relevance of this study is that caution and precise preoperative diagnostics are needed to avoid failure of intra-articular ACL reconstruction if the extra-articular stabilizers are torn.
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Arch Orthop Trauma Surg · Aug 2010
Implant-free press-fit fixation for bone-patellar tendon-bone ACL reconstruction: 10-year results.
The aim of this study is to determine the outcome of anterior cruciate ligament (ACL) reconstruction without foreign material with patellar tendon bone graft in the fixation with bone dowels near the native insertion. ⋯ The implant-free fixation of the graft with bone dowels and BTT implantation has good and excellent results after 10 years in more than 80% of the patients. Loss of the meniscus is a main factor contributing to osteoarthritis. Advantages of patellar tendon bone press-fit fixation include anatomical positioning and fast bone-to-bone healing, ease for revision surgery and cost effectiveness.
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Arch Orthop Trauma Surg · Aug 2010
Location and classification of popliteus tendon's origin: cadaveric study.
In posterolateral insufficiency, many investigators have proposed a lateral tunnel for PT reconstruction. Although they were usually located at the anterior and proximal to the lateral femoral epicondyle, there are still controversies regarding the exact location of PT tunnel. The aim of the present study was to describe our novel findings of femoral attachment of popliteus tendon (PT) and lateral collateral ligament (LCL) and to present an adequate femoral tunnel site, based on the cadaver dissection. ⋯ If the original site of the PT's attachment cannot be seen, the recommendation of the femoral tunnel for the PT reconstruction should be located at the postero-inferior site as compared with the LCL attachment in the fully extended position.