Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
-
Knee Surg Sports Traumatol Arthrosc · Mar 2008
Clinical TrialArthroscopic screw fixation of large anterior glenoid fractures.
Ten patients after traumatic shoulder dislocation with resulting instability due to an acute anterior glenoid fracture involving at least 21 percent of the glenoid length were treated by arthroscopic screw fixation of the fragment. The average fragment size measured 26.2% of the glenoid length. Pre- and postoperative radiographic evaluations were performed with three-dimensional CT scans. ⋯ One patient had one episode of traumatic redislocation with a positive apprehension test at follow up. In one case, removal of the screw was necessary due to mechanical impingement. We recommend this arthroscopic technique allowing for closed reduction and internal screw fixation of large anterior glenoid fractures, ensuring anatomical fracture healing and gleno-humeral joint stability.
-
Knee Surg Sports Traumatol Arthrosc · Mar 2008
Reliability of bony landmarks for restoration of the joint line in revision knee arthroplasty.
The aim of this study was to determine the reliability of bone landmarks for restoring the joint line in revision knee arthroplasty. The relationship of the femoral epicondyles, the tibial tubercle (TT) and the fibular head (FH) to the joint line was measured on 200 magnetic resonance imaging (MRI, 100 females, 100 males), including assessment on intraobserver and interobserver reliability. MRI scans demonstrating chondral lesions and osteoarthritis were excluded, as were patients with immature skeletons or a history of previous knee surgery. ⋯ Considering this findings, the FH is not a reliable guide for the joint line in revision surgery. Previous studies have measured the absolute values from various landmarks to the joint line. This study provides a significant advantage, in that the level of the joint line can be determined for each individual by using a ratio to account for gender and size differences.
-
Knee Surg Sports Traumatol Arthrosc · Mar 2008
Articular cartilage injury of the posterior lateral tibial plateau associated with acute anterior cruciate ligament injury.
Thirty-nine knees in 39 patients with recent anterior cruciate ligament (ACL) rupture (age 14-55 years; with a mean age of 22.8 years) were selected from our cases of ACL reconstruction from July 2005 to June 2006, to take part in a study on articular cartilage injury of the posterior lateral tibial plateau associated with acute ACL injury and on the correlation between bone bruises depicted on MRI and cartilage injury of the posterior lateral tibial plateau detected at arthroscopic ACL reconstruction. Using preoperative MRI, we evaluated whether there were bone bruises or not in the lateral compartment of the knee and divided them accordingly into two groups: the bone bruise positive group and the negative group. The differences in the proportions of the lateral meniscus (LM) tears and the cartilage injuries in the two groups were evaluated using Fisher's exact probability test. ⋯ There was a statistically significant correlation between the proportion of bone bruise and cartilage injury of the lateral femoral condyle (P = 0.004), that of the posterior lateral tibial plateau (P = 0.04) and that of tears in the LM posterior horn (P = 0.008). This current study has demonstrated that we need to pay attention to cartilage damage of the posterior lateral tibial plateau as well as to posterior horn tears in LM, when acute ACL injury is shown. We also have to ensure that we follow the long-term progress of cartilage injuries, with the aim of preventing these injuries becoming osteoarthritis after ACL reconstruction.