Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Jan 2002
Clinical Trial Controlled Clinical TrialHigh tibial osteotomy in knee instability: the rationale of treatment and early results.
We treated 14 patients having knee instability and varus alignment with tibial osteotomy with or without ligament reconstruction. Five patients with varus angulated anterior cruciate deficiency (double varus) were treated with single-stage closed-wedge tibial osteotomy and anterior cruciate ligament reconstruction. The remaining nine patients had varying amount of posterior cruciate and postero-lateral corner ligament injuries with varus angulation (triple varus); six of these patients had a ligament reconstruction using the Ligament Advanced Reconstruction System ligament with tibial osteotomy (intra-articular--posterior cruciate ligament/extra-articular--postero-lateral corner reconstruction), while the remaining three had a tibial osteotomy without a ligament reconstruction. ⋯ Accordingly, there were two poor, four fair and eight good results. In-patients with triple-varus, open-wedge tibial osteotomy had better scores than those with closed-wedge procedure. The results of this series are encouraging, and we recommend a high tibial osteotomy along with ligament reconstruction in these complex injuries with varus alignment.
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Knee Surg Sports Traumatol Arthrosc · Jan 2002
Strain patterns in the patellar tendon and the implications for patellar tendinopathy.
This study investigated the strain pattern in human patellar tendon in an area of the tendon where changes commonly associated with patellar tendinitis are found. Eight fresh frozen human knees were instrumented with strain gauges on both the anterior and posterior side of the proximal patellar tendon. Both static and dynamic measurements were carried out in a range from 0 degrees to 60 degrees of flexion. ⋯ The posterior side of the proximal patellar tendon is most commonly affected in patellar tendinopathy. This study indicates that this area of the tendon may not subjected to the highest tensile loads in the functional flexion range. It is possible that stress shielding is more important etiological factor in insertional tendinopathy as opposed to repetitive tensile loads.