Unstable osteoarthritis genu varum. Our experience

Sports Medicine, 2007

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2015

Aim of this study was to record and compare the functional and activity level as well as the manifestations of osteoarthritis after isolated ACL ruptures between patients with conservative treatment and ACL reconstruction with hamstrings tendon graft. Thirty-two patients diagnosed with ACL rupture were recorded. Clinical examination included the Tegner and Lysholm activity scale, the International Knee Documentation Committee Subjective Form and KT-1000 arthrometer. Narrowing of the medial and lateral joint spaces was assessed using the IKDC knee examination score. Median follow-up was 10.3 years (range 10-11). Fifteen patients were conservatively treated (median age 33 years, range 25-39). Seventeen patients were operated (median age 31 years, range 20-36). There was significant difference between the mean values of IKDC scores in favour of the ACL-reconstruction group of patients, 86.8 (SD 6.5) versus 77.5 (SD 13.8), respectively (p = 0.04). The mean value of anteroposterior tibia...

Journal of Orthopaedic Surgery and Research, 2008

Objective: The objective of this study was to evaluate the incidence of radiographic osteoarthritis in the operated knee in comparison with the contralateral knee ten years after a bone-tendon bone patellar autograft ACL-reconstruction and to evaluate to which level patients regain activity ten years after reconstruction.

Although not life-threatening, rupture of the anterior cruciate ligament (ACL) can severely impair activities of daily living and quality of life. ACL reconstruction is an accepted modality of treatment but failure rates as high as 25% have beeb reported. In view of this, we reviewed the clinicaloutcome of 33 patients who had undergone arthroscopic-assisted autogenous graft reconstruction using either patella-tendon or hamstring graft following anterior cruciate ligament (ACL) rupture in UMMC between 2000 to 2003. This study was also conducted to compare the outcome of the two different types of autogenous graft used for ACL reconstruction which are the bone-patella tendon-bone (BPB) and hamstring (HS) grafts. Patients between the ages of 17 to 48 years (mean age of 27.8 years) were evaluated at 1 to 3 years post-operatively using various clinical parameters which include functional index, subjective and objecyive scores and an objective measurement using KT 1000 arthrometer. On the overall, patients operated in our centre did well with 6% (n=2) failures reported. Both the BPB and HS groups had good to excellent results post operatively. Ninety seven percent (n=32) of the patients were able to kneel and squat with more than half of them achieving >90% single-legged hop test. Eighty eight percent of patients (n=29) achieved normal to nearly normal subjective IKDC score. The mean Lysholm score was 92.2, with 97% (n=32) scored excellent (80 points or more). More than 90% had equal or less than 2 Tegner activity-level drop. The mean KT 1000 side by side differences was 1.71mm, with 94% had less than 4mm difference. Even though the BPB group was observed to have a higher mean Lysholm score (92.6%) compared to the HS group (91.8%), they were statistically significant. The BPB group had a significantly less residual laxity with the KT 1000 side to side different of 1.1mm compared with the HS group of 1.9mm. However no correlation between laxity and any of the outcome scores were noted. In conclusion, ACL reconstruction procedures performed in UMMC have yield good to excellent short term results.

The American Journal of Sports Medicine, 2008

2013

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The Anterior Cruciate Ligament: Reconstruction and Basic Science, 2008

2010

The mechanisms of anterior cruciate ligament (ACL) injuries are still inconclusive from an epidemiological standpoint. An epidemiological approach in a large sample group over an appropriate period of years will be necessary to enhance the current knowledge of the ACL injury mechanism. The objective of the study was to investigate the ACL injury occurrence in a large sample over twenty years and demonstrate the relationships between the ACL injury occurrence and the dynamic knee alignment at the time of the injury. We investigated the activity, the injury mechanism, and the dynamic knee alignment at the time of the injury in 1,718 patients diagnosed as having the ACL injuries. Regarding the activity at the time of the injury, "competition "was the most common, accounting for about half of all the injuries. The current result also showed that the noncontact injury was the most common, which was observed especially in many female athletes. Finally, the dynamic alignment of "Knee-in & Toe- out "(i.e. dynamic knee valgus) was the most common, accounting for about half. These results enhance our understanding of the ACL injury mechanism and may be used to guide future injury prevention strategies. Key pointsWe investigated the situation of ACL injury occurrence, especially dynamic alignments at the time of injury, in 1,718 patients who had visited our institution for surgery and physical therapy for twenty years.Our epidemiological study of the large patient group revealed that "knee-in & toe-out "alignment was the most frequently seen at the time of the ACL injury.From an epidemiological standpoint, we need to pay much attention to avoiding "Knee-in & Toe-out "alignment during sports activities.

The Knee, 1999

The purpose of this study was to evaluate the results at minimum 2 years follow-up of our original hamstrings technique, with intra and extra articular ACL plasty, followed by an aggressive rehabilitation program. Forty young sports practising patients were prospectively selected. IKDC score, Lysholm scale score as well as KT 2000 and isokinetic tests with a Lido Ž. machine Lido CA were used for patient evaluation. Ninety percent of the patients had a negative Lachman test and 85% experienced no pivot shift. Valgus rotation was 1 q in 22.5% of the cases. KT 2000 evaluation showed a similar trend in the three tests performed, with an average injuredruninjured difference of 2.1 mm. The results confirm our original hamstrings technique efficacy and its low morbidity. Patients with residual valgus laxity in relation to partial MCL tears had significantly higher KT parameters and consequently less favourable outcome. An aggressive rehabilitation reduces sensitively the sport recovery time without affecting knee stability.