Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
-
Knee Surg Sports Traumatol Arthrosc · Aug 2006
Case ReportsSimultaneous bilateral posterior dislocation of the shoulder: diagnostic problems and management. A case report.
We present the case of a patient who sustained simultaneous bilateral posterior dislocation of the shoulder after a possible epileptic fit. The confirmation of the diagnosis was reached only by a computed tomography (CT) scan, after the clinical suspicion. ⋯ When the history describes an electric shock or convulsive seizure, any shoulder injury demands a careful clinical and radiological evaluation. It is usually associated with reverse Hill-Sachs lesion (an impression defect of the anteromedial aspect of the humeral head), in which the size determines the treatment options.
-
Knee Surg Sports Traumatol Arthrosc · Aug 2006
Injuries to the infrapatellar branch(es) of the saphenous nerve in anterior cruciate ligament reconstruction with four-strand hamstring tendon autograft: vertical versus horizontal incision for harvest.
The goal of this study is to evaluate the incidence rate of iatrogenic injuries to the infrapatellar branch(es) of saphenous nerve during ACL reconstruction with four-strand hamstring tendon autograft. Retrospective review of 226 patients that underwent 230 arthroscopically assisted primary ACL reconstructions with four-strand hamstring tendon autograft, between March 2002 and December 2004. The patients were separated into two groups. ⋯ In patients of group 2 the incidence of nerve injury was 14.9% (P<0.001). The horizontal surgical incision in harvesting hamstrings tendon autograft for ACL reconstruction was found to have less associated chance of iatrogenic injury to the infrapatellar branch(es) of the saphenous nerve. No technical ties were found in both incisions for graft harvest.
-
Knee Surg Sports Traumatol Arthrosc · Aug 2006
Meniscal allograft transplantation: long-term clinical results with radiological and magnetic resonance imaging correlations.
Long-term data on the clinical outcome and the fate of the meniscus allograft after transplantation are scarce. In this study we present the clinical, radiological and MRI outcome of the meniscus graft and the articular cartilage after 42 meniscus allograft transplantations in 41 patients with a minimum follow-up of 10 years. A total of 27 medial and 15 lateral meniscal allografts were transplanted. ⋯ Despite this significant improvement, substantial disability and symptoms were present in all investigated subgroups. Progression of further cartilage degeneration or joint space narrowing was absent in a considerable number of cases, indicating a potential chondroprotective effect. Level of evidence is therapeutic study, Level IV and retrospective analysis of prospectively collected data.
-
Knee Surg Sports Traumatol Arthrosc · Jul 2006
The influence of walking speed on gait parameters in healthy people and in patients with osteoarthritis.
It is difficult to identify objective parameters for assessing the joint function when evaluating the outcome of orthopaedic procedures, especially endoprosthetic replacement. Spatial and temporal parameters of gait have clinical relevance in the assessment of motor pathologies, particularly in orthopaedics. However, the influence of gait speed on these biomechanical parameters has been difficult to be taken into consideration so far. ⋯ Our findings indicate that the changes in gait parameters may occur in patients with unilateral osteoarthritis of the hip joint or the knee joint compared to the gait pattern of healthy control subjects. Hip joint or knee joint degeneration was compensated for in part by the pelvis and other joints in the lower limb. Reduced motion of the hip joint or knee joint leads to an increased pelvic motion, which should affect the natural mobility of the lumbar spine and cause pain in the lumbar region of the spine because of their kinematic interaction.
-
Knee Surg Sports Traumatol Arthrosc · Jun 2006
Randomized Controlled TrialRandomized prospective study of ACL reconstruction with interference screw fixation in patellar tendon autografts versus femoral metal plate suspension and tibial post fixation in hamstring tendon autografts: 5-year clinical and radiological follow-up results.
Patellar tendon graft has been the most frequently used material in anterior cruciate ligament (ACL) reconstruction, but the hamstring tendons have been increasingly used as well; however, which graft is to be preferred is not adequately supported by existing clinical studies. In this prospective randomized clinical trial, the study hypothesis was that the hamstring tendons are equally good graft material as the patellar tendon in ACL reconstruction. Ninety-nine patients with laxity due to a torn ACL underwent arthroscopically assisted reconstruction with graft randomization according to their birth year to either patellar tendon with metal interference screw fixation or double looped semitendinosus and gracilis tendons with fixation similar to the Endobutton technique using a titanium metal plate suspension proximally and screw-washer postdistally. ⋯ The results revealed no statistically significant differences with respect to clinical and instrumented laxity testing, isokinetic muscle torque measurements, International Knee Documentation Committee ratings, Lysholm (knee score), Tegner (activity level) and Kujala patellofemoral knee scores. There was an enlargement of the drill tunnels, statistically more in the hamstring tendon group, but no increase from 2 to 5 years in either group. Narrowing of the joint spaces (IKDC measurement method) from 2 to 5 years postoperatively was seen in both the groups, however, without difference between the two groups.