Biomedical subjects

J Gillquist

Publications and source records attributed to J Gillquist.

202 records · Page 12Linked to original sources

PubMedDate not supplied

Reconstruction of old anterior cruciate ligament tears with a Dacron prosthesis. A prospective study.

Seventy patients with chronic anterior instability underwent anterior cruciate ligament reconstruction with a Dacron prosthesis pretensioned to 60 N. Of these patients, 49% (34%) had combined medial instability, 32% (22) had failed previous anterior cruciate ligament surgery, and 37% (26) had previous meniscectomy. At reconstruction, 12 patients had their medial instability treated; 22 did not. Follow-up intervals were 3, 6, and 12 months and then each year to 5 years. The 5-year followup included 69 patients; the other 1 had the ligament removed because of a synovial fistula at 8 months. Results were 23% prosthesis ruptures, 3% poor, 17% fair, 16% good, and 39% excellent. The 2-year results showed the same distribution, but a lower rupture rate, which was affected by placement of the tibial tunnel within the anterior one-third of the tibia (9 times increase) and coexisting nonrepaired medial instability (5 times increase). Those patients with perfect placement of the ligament who also had good medial stability and no previous ligament surgery had no rupture at 5 years. The stability that was gained at surgery was gradually lost (-11.2% per year). At 5 years, the uninjured knee also had lost 41% of the preoperative stability; the mean laxity difference was within +/- 2 mm. The mean improvement in subjective knee function (Lysholm score 74.5 to 91.9) was maintained during the followup. The mean preoperative activity level improved significantly, but did not reach the preinjury level. These results show that the Dacron prosthesis will not give acceptable results in salvage cases where other instabilities are left untreated.

Adolescent↗

PubMedDate not supplied

Sagittal knee stability after anterior cruciate ligament reconstruction with a patellar tendon strip. A two-year follow-up study.

Tibial anteroposterior displacement after anterior cruciate ligament reconstruction with a patellar tendon graft was followed prospectively for 2 years in 24 patients with an arthrometer. The femoral ligament insertion location, in a lateral projection, and the change in intraarticular fixation distance, measured with an isometer, were documented intraoperatively. Two years after surgery, the overall mean injured-noninjured difference in anteroposterior displacement was 2.0 +/- 2.3 mm. All grafts were fixed during surgery at 20 degrees of knee flexion. Patients for whom this angle coincided with the angle of minimum intraarticular fixation distance (Group I), and patients who had a femoral ligament insertion location > 2 mm anterior to the center of the normal anterior cruciate ligament attachment (Group A) showed larger tibial displacement than the other patients. An injured-noninjured difference in tibial anteroposterior displacement > or = 3 mm was classified as failure. Groups I and A failure rates were higher than for the other patients. No correlation was found between anteroposterior displacement and magnitude of the change in intraarticular fixation distance. We conclude that anterior femoral locations lead to larger sagittal play after 2 years than central or posterior locations and that the magnitude of the fixation distance is less important than the pattern.

Adult↗

PubMedDate not supplied

Long-term results of anterior cruciate ligament reconstruction with a Dacron prosthesis. The frequency of osteoarthritis after seven to eleven years.

In this prospective study we investigated 70 patients with chronic anterior instability who underwent anterior cruciate ligament reconstruction with a Dacron prosthesis. Fifty-five (79%) patients could be followed up at a mean of 9 years. Within the follow-up time, 44% (29 of 66) of the prostheses were diagnosed as ruptured; the annual rupture frequency was 5%. Second reconstructions were performed for 20 patients (29%), 5 patients had third reconstructions, and 9 patients wanted no further surgical treatment. Fifty-two patients (74% of the original group) underwent radiographic examination. Eighty-three percent (43) of these patients had radiographic changes in the operated knee, and 40% (21 of 52) had joint space reduction up to 50%. The rate of radiographically detected osteoarthritis was increased 10 times compared with the normal knee. Patients with medical instability and patients older than 30 years at the initial operation had more severe osteoarthritic changes. Based on the functional results of the patients with a ligament in place after 9 years, only 14% (10) of the original group had acceptable stability and knee function.

Adolescent↗

PubMedDate not supplied

Sagittal plane translation of the knee during stair walking. Comparison of healthy and anterior cruciate ligament--deficient subjects.

With an electrogoniometer system, we made bilateral measurements of the maximal sagittal plane anterior-posterior knee translations in 15 healthy subjects (controls) and 14 patients with arthroscopically confirmed unilateral anterior cruciate ligament deficiency during two types of ascents and descents (straight and side). In both groups, during the ascent cycle the tibia moved anteriorly in relation to the femur, whereas during the descent cycle it moved posteriorly. There was wide individual variation in maximal translation in both the control and anterior cruciate ligament-deficient groups (range, 1 to 12 mm; mean, 7 mm). The maximal translations were similar in both groups (P > 0.05), but they occurred at a significantly smaller flexion angle in the injured knees (38 degrees +/- 8 degrees) than in the control and non-injured knees (44 degrees +/- 8 degrees) (P < 0.05). The translation during step ascent and descent did not differ between the injured and control knees. These findings indicate that patients with anterior cruciate ligament injuries are able to control abnormal anterior translation during normal activity.

Adolescent↗