Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Mar 2007
Reconstruction of the anterior cruciate ligament: dynamic strain evaluation of the graft.
The study is focused on the biomechanical aspects of the anterior cruciate ligament (ACL) reconstruction procedures with an emphasis on evaluating the dynamic strain of materials commonly used for this purpose. Separate and multiple, equally tensioned strands of hamstring grafts used for the reconstruction of the ACL were biomechanically tested and compared to original ACL and bone-patellar tendon-bone (BPTB) grafts, using tissue samples from cadavers. The study was focused on measuring such material properties as the strength, stiffness, maximum load, and elongation at maximum load of the original ACL, BPTB graft, and single tendon hamstring (gracilis and semitendinosus) grafts, continued by double strands and finally by four-strand graft (STG) evaluation. ⋯ No significant changes in maximum loads/stresses were observed under impact loading conditions. The results of this study demonstrate that equally tensioned four-strand hamstring-tendon grafts have higher initial tensile properties than those in other varieties of samples. From a biomechanical point of view, they seem to be a reasonable alternative procedure for ACL reconstruction.
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Knee Surg Sports Traumatol Arthrosc · Mar 2007
Trochlear osteotomy for patellar instability: satisfactory minimum 2-year results in patients with dysplasia of the trochlea.
Trochlear dysplasia is a predisposing factor for recurrent patellar instability. We evaluated the results of an anterior lateral femoral condyle open wedge osteotomy for treating patellar instability. A total of 16 consecutive patients (19 knees) with symptoms of recurrent patellar instability and trochlear dysplasia identified using a true lateral radiograph of the knee underwent an anterior lateral femoral osteotomy. ⋯ Anterior femoral osteotomy of the lateral condyle appears to be a satisfactory and safe method for treating patients with patellofemoral joint instability caused by trochlea dysplasia. In selected cases this procedure can be used to correct trochlea dysplasia. In our opinion, the key to a successful treatment of patellofemoral instability is to successfully distinguish the anatomic deficiencies and to correct the anatomical abnormality.