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At least 379 records · Page 21Linked to original sources
PubMed1990

[Follow-up results of ligament replacement by PDS in chronic lateral ligament instability of the upper ankle joint].

From September 1988 till February 1989 we have operated on 14 PDS-ligament replacements of the ankle in patients with chronic lateral instability. Only one patient had an excellent clinical result with a stable ankle. Ten of twelve patients had poor results at follow-up. 2 patients had been reoperated on. We did not find biological substitute along the PDS guide line. This suggested the opinion, the PDS-ligament replacement of the ankle can't realize the expectations.

Adolescent↗
PubMed1989

[Elastometric study of the distal scaphoid ligamental complex and the scapho-lunar ligament].

Six wrists from fresh cadavers have formed the subject of a functional, histological and biomechanical study. This one has been realized by two methods: the one analytical, the other in the whole and in situ. The diverse experiences show up the pre-eminent role of the distal scaphoid ligamentous complex relative to the scapholunar ligament. This fact is in opposition to the generally admitted theories. It modifies the therapeutic approach to lateral carpal instabilities.

Biomechanical Phenomena↗
PubMed1987

[A holder for plain x-ray visualization of ulnar, volar and radial injuries of the capsule and ligaments of the basal thumb joint. A hyperextensometer for the determination of the ligamentous laxity of the index finger basal joint].

We have constructed a device for standardized radiodiagnostics of ulnar, volar, and radial capsulo-ligamentous lesions of the basal thumb joint. Used as hyperextensometer at the basal joint of the index finger, the device is of equal value in the diagnosis of ligamentous laxity.

Finger Injuries↗
PubMed1985

Associated joint pathology in the anterior cruciate ligament-deficient knee with emphasis on a classification system and injuries to the meniscocapsular ligament-musculotendinous unit complex.

This article defines the anterior cruciate ligament-deficient knee in terms of capsular instabilities. This definition lends itself to a better assessment of the associated pathology consisting of torn capsular ligaments, torn medial and lateral menisci, chondral fractures, subluxation of the patella, and acute contusion of the peroneal nerve. The specific incidence of torn medial meniscus was 70 per cent, with a torn lateral meniscus identified 77 per cent of the time.

Humans↗
PubMed1985

Long-term results of desmotomy of the accessory ligament of the deep digital flexor tendon (distal check ligament) in horses.

After desmotomy of the accessory ligament of the deep digital flexor tendon (distal check ligament) had been performed in 40 horses with flexural deformity of the distal interphalangeal joint (contracture of the deep digital flexor tendon), the horses' records were evaluated retrospectively. Information concerning soundness, return to intended purpose, and cosmetic appearance of the limb and hoof was obtained. The condition had been diagnosed and treated in 26 horses before they were one year old (group A, acute) and in 14 horses greater than one year of age (group B, chronic). Nine months to 4 years after surgery, 35 horses (24 from group A, and 11 from group B) were not lame and were being used as athletes. Thirty-three horses were being used for what the owner had intended before the development of the flexural deformity, and 7 were not. Of these 7 horses, 6 had complications related to the deformity, whereas one had complications resulting from surgery.

Animals↗
PubMed2000

Treatment of combined anterior cruciate ligament-posterior cruciate ligament-lateral side injuries of the knee.

ACL-PCL-posterolateral corner injuries most frequently are seen in multiple trauma patients but do occur in the athletic injury population. Acute three-ligament-injured knees may have been tibiofemoral dislocations with spontaneous reduction in the field. Careful documentation of the neurovascular status is essential in these cases to avoid the complications associated with limb ischemia. Systematic evaluation of these patients with history, physical examination, imaging studies, examination under anesthesia, and diagnostic arthroscopy will aid in the correct diagnosis and treatment plan formulation. Arthroscopically assisted, combined ACL-PCL-posterolateral complex reconstructions, using strong graft material, and performed in a timely fashion, have provided consistent and predictable results with few complications.

Anterior Cruciate Ligament↗
PubMed2004

Transtibial tubercle fixation without hardware for anterior cruciate ligament and posterior cruciate ligament reconstruction: A new technique.

Tibial fixation with implants for both anterior and posterior cruciate ligament reconstructions (ACLR and PCLR) can be associated with a wide variety of problems. Common problems encountered include graft-tunnel mismatch when using grafts with bone blocks, graft damage or poor graft fixation using metal or absorbable implants, painful retained hardware requiring removal, and hardware interference during revision surgery. A new technique is presented using transosseous graft suture passage across the tibial tubercle followed by knot tying over a bone bridge. The technique provides a quick, simple, safe, and reproducible alternative for primary or supplemental tibial graft fixation without hardware in ACLR and PCLR.

Anterior Cruciate Ligament↗
PubMed2000

Surgical treatment of combined injury to anterior cruciate ligament, posterior cruciate ligament, and medial structures.

Injuries involving the anterior cruciate, posterior cruciate, and medial collateral ligaments represent one combination of injuries representing knee dislocation. Prompt reduction and neurovascular evaluation are necessary when treating these injuries. Operative management involving reconstruction and repair of the injured structures produces optimal results. This article outlines the principles involved in evaluating and managing these injuries, combined with specifics of the authors' treatment approach, and review of the literature.

Anterior Cruciate Ligament↗
PubMed1997

The relationship between anterior cruciate ligament reconstruction tibial tunnel location and the anterior aspect of the posterior cruciate ligament insertion.

A retrospective study of arthroscopic anterior cruciate ligament reconstruction in 20 patients was conducted. These patients underwent computed tomography (CT) scans on the involved knee postoperatively to determine sagittal placement of the proximal end of the tibial tunnel (TTp) based on a distance from a specific anatomic reference known as the over-the-back (OTB) ridge. The distance from the posterior aspect of the TTp to the OTB ridge, defined as the backset, was measured from the CT scans. The mean backset was 6.2 mm. The anterior to posterior (AP) tibial plateau diameter was measured from the CT and by plain view radiograph. The mean AP diameter by CT scan was 55.1 mm and the mean AP diameter by radiograph was 55.4 mm. A Pearson correlation coefficient of r = .633 comparing backset versus AP diameter suggests a moderately significant positive relationship. For the AP diameter comparing measurement method, CT versus radiograph, r = .985, representing a highly significant positive relationship, confirming AP diameter sizing accuracy by inexpensive radiography versus CT scan. A proposed backset model based on these data uses three fixed distances, derived by ratio, within a 2-mm range. This model is defined by 5-, 6-, and 7-mm backset intervals for < 50 mm, 50 to 60 mm, and > 60 mm AP diameters respectively, and is currently under prospective clinical investigation.

Adult↗
PubMed1998

[MRI of knee ligaments: error analysis with reference to meniscus and anterior cruciate ligaments in an arthroscopic controlled patient cohort].

PURPOSE: To categorise discrepancies in findings of the menisci and anterior cruciate ligament (ACL) between arthroscopy and MRI. MATERIALS AND METHODS: The MRIs of 236 patients were retrospectively analysed by an experienced radiologist without knowledge of clinical and/or operative findings. Discrepancies in arthroscopic findings were reevaluated together with the arthroscopist to determine their cause of error. RESULTS: The diagnostic accuracies for injuries of the medial and lateral meniscus and the ACL were 92.4%, 92.4%, and 94.1%, respectively. For the menisci, causes for discrepancies in findings (n = 31) were: overinterpretation of central signal intensities with contact to the meniscal surface but without disturbance of the meniscal contour as a tear (n = 12), insufficient arthroscopie evaluation of the knee joint (n = 11), overlooked tears on MR imaging (n = 6), misinterpretation of normal anatomic structures (n = 1), "magic angle" phenomenon (n = 1), and missed tears at MRI (n = 1). Causes for discrepancies for the ACL (n = 18) were: nearly complete versus complete rupture either at MRI or arthroscopy and vice versa (n = 9), insufficient arthroscopic evaluation (n = 6), insufficient MRI technique (n = 2), and overlooked tear on MR imaging (n = 1). CONCLUSIONS: Discrepant findings between MRI and arthroscopy may be also due to an insufficient arthroscopic evaluation in clinical routine. The close cooperation between surgeons and radiologists improves the understanding of the methods of each other.

Adolescent↗
PubMed2000

Long-term results of anterior cruciate ligament reconstruction using semitendinosus and gracilis tendons with Kennedy ligament augmentation device compared with patellar tendon autografts.

ACL reconstructions were postoperatively evaluated in 102 patients who underwent surgery using an arthroscopically assisted double-incision technique. Augmentation of the distally based semitendinosus and gracilis tendons was done either with the Kennedy ligament augmentation device (LAD) (Group 1 patients, mean follow-up of 108 months) or bone-patellar-tendon-bone graft (Group 2 patients, mean follow-up of 109 months). At follow-up, serial KT-1000 measurements showed < or = 5 mm side-to-side differences in 70% of Group 1 and 90% of Group 2 patients. No differences were found among patients regarding postreconstruction complications such as loss in motion range, patellofemoral crepitus, osteoarthritis, and muscle disfunction.

Activities of Daily Living↗
PubMed2002

[Arthroscopic reconstruction of the anterior cruciate ligament using the transtibial technique and a graft from the patellar ligament--results after 5-6 years].

PURPOSE OF THE STUDY: Arthroscopic reconstruction of the anterior cruciate ligament (ACL) by transtibial technique with free graft from the patellar tendon fixed by interference screws is a commonly used procedure. The aim of this study is to evaluate the results 5 to 6 years after the surgery. MATERIAL: Fifty-two of 79 patients operated on in 1995 were checked in the period of 2000-2001. The average age of patients at the time of surgery was 26 years (range, 15-20 years), there were more men (62%), prevailing were injuries resulting from sports activities (92%). METHOD: We have used evaluation according to IKDC. We focused on the problems at the site from which the graft was harvested, on the difficulties in the kneeling position and walking on knees. Evaluation of the activity was based on the Tegner score. On radiographs we assessed the length of the patellar tendon, dilatation of the tibial canal and the incidence and degree of osteoarthritis. RESULTS: General evaluation according to IKDC was normal or nearly normal in 79% of patients. The difference of the anterior displacement of tibia between the operated on and non-operated on knee measured by arthrometer (KT 1000, 89N) was < 3 mm in 58% of patients and < or = mm in 95% of patients. Significant difficulties on the operated on side in the kneeling position and walking on knees were reported by 3 patients, slight difficulties were reported by 28 patients. Twenty patients reported slight difficulties also on the non-operated on side. Prior to the injury the average level of activity after Tegner was 7.9 (range, 6-10), prior to the operation 2.7 (range, 0-6) and at the time of check examination 7.0 (range, 4-10). The same level of activity as before the injury was reported by 61.5% of patients. Shortening of the patellar tendon on the operated on side > 5% (6 mm) was found out in 1 patient, shortening of < or = 5% (2-3 mm) in 30 patients. Tibial canal on the lateral projection 1 cm beneath the joint line was wider than 10 mm (dilated) in 6 patients. On the operated on knee osteoarthritis was found of the medial compartment of degree B and C in 42% of patients and on the non-operated knee in 19% patients. Aggravation of osteoarhritis of the medial compartment by one degree occurred after 5 to 6 years after the surgery in 4 out of 20 patients. All of them underwent meniscectomy. Eighty-six per cent (19 of 22) of patients with osteoarthritis of the medial compartment underwent medial meniscectomy. DISCUSSION: General results according to IKDC are compared with results published by Aglietti, Jomha and Patel. Dilatation of the tibial canal was found out in 6 patients and it was associated with the graft-tunnel mismatch. The relationship between meniscectomy and arthritis is well-know. In 31% of patients after medial meniscectomy there was found out narrowing of the joint line to 2-4 mm (degree C). In case of partial medial meniscectomy the posterior horn, i.e. the most important part of the meniscus, was in most cases removed. Worsening of the arthritis after resection of the minor radial lesions of the lateral meniscus or after leaving incomplete lesions of the posterior horn of the lateral meniscus untreated has not been observed. CONCLUSION: The surgery allows to improve the stability and extent of activity in most of the patients. The most frequent problem consists in the difficulties at the site of graft harvesting which may contribute to the decrease of subjective satisfaction. The relation between shortening of the patellar tendon and patellar difficulties was not proved. In the patients after medial meniscectomy osteoarthritis progresses even after ACL reconstruction.

Adolescent↗
PubMed2003

Arthroscopic reconstruction of anterior cruciate ligament using BTB patellar ligament in the press-fit technique.

Arthroscopic reconstruction of the anterior cruciate ligament (ACL) with a bone-patellar tendon-bone graft in the press-fit technique is an efficient procedure, which provides high primary stability without use of implants and thus ensures early functional rehabilitation. The procedure is based on graft harvest with an oscillating hollow saw, which allows collection of cylindrical bone blocks. Femoral fixation using a template and file has been standardized to an extent that ensures secure press-fit fixation. Tibial anchorage is achieved by refilling the tibial tunnel with the bone cylinder removed previously. Primary stability is at least equivalent to that achieved with interference screw or staple fixation, and has been evaluated in a pull-out study in ovine knees. Two major problems encountered with revision procedures--metal removal or tunnel enlargement--may be avoided effectively. In a prospective study of 32 patients, postoperative computed tomography (CT) evaluation after three months showed presence of cancellous bone material inserted into the tibial tunnel. Postoperative tunnel enlargement seen frequently with other procedures can be avoided in almost all knees. Revision procedures after press-fit fixation can be done without problems. This procedure provides a cost-efficient alternative for reconstruction of the ACL, because it does not require implants.

Anterior Cruciate Ligament↗
PubMed1993

The anterior cruciate ligament in the multiple ligament-injured knee.

The ACL may be associated with concomitant injury to the posterior cruciate ligament, collateral structures, bone or cartilage. An approach to the multiligament injured knee is discussed including evaluation, treatment, graft selection, operative techniques, graft placement, tensioning, fixation, impingement, postoperative care, and complications.

Anterior Cruciate Ligament↗
PubMed1998

[Evaluation of results after arthroscopic reconstruction of the anterior cruciate ligament with a free graft of the patellar ligament].

From among 312 patients treated with arthroscopic anterior cruciate ligament reconstruction (one-incision, transtibial with the use of ipsilateral bone-patellar tendon-bone autograft) between 1992 and 1994 256 (82%) were reviewed with a mean follow-up of 26.4 months. An aggressive rehabilitative protocol advocated by Shelbourne has been employed. Stability of the knee has been assessed with KT-1000 arthrometer and IKDC and OAK forms served to evaluate the results. In 77% of the cases nearly normal function of the knee has been restored (87% excellent and good results in OAK form). Arthroscopic technique and aggressive rehabilitation decreased the number of patients with peripatellar pain and improved patient's acceptance of the management. Competitive athletes seem to achieve best end-results.

Adolescent↗
PubMed2000

Cervical curvature after laminoplasty for spondylotic myelopathy--involvement of yellow ligament, semispinalis cervicis muscle, and nuchal ligament.

To assess the consequences of cervical laminoplasty on postoperative lordosis, a retrospective radiographic analysis of 31 patients undergoing laminoplasty for spondylotic myelopathy was completed. Special attention was paid to lordotic changes occurring at each level over more than 2 years. Preoperative lordosis remained unchanged with the patients wearing a cervical orthosis 1 week postoperatively. However the lordosis subsequently demonstrated a significant decrease in 87% of patients over an average of 3.1 years. Lordotic alignment at C2-C3 and C6-C7 before surgery significantly decreased in 81% and 58% of patients 1 week postoperatively, and 84% and 81% at last follow up, respectively, while lordotic alignment at other levels pre- and postoperatively did not significantly change. Loss of lordotic alignment was largely attributed to detachment of semispinalis cervicis muscle on C2 and nuchal ligament on C6/C7 with a posterior approach and/or section of yellow ligament at C2-C3.

Adult↗
PubMed2005

["Isolated" injury of the posterior cruciate ligament. Surgical treatment of isolated posterior cruciate ligament tears: a multicentric retrospective study of 103 patients].

PURPOSE OF THE STUDY: We present a retrospective multicentric series of carefully selected patients presenting "isolated" laxity of the posterior cruciate ligament. MATERIAL AND METHODS: The series included 103 patients who were reviewed clinically (with a dedicated review chart) and radiographically with measurement of posterior laxity (Telos 15 kg). RESULTS: In these patients with an isolated injury of the PCL (without associated injury of the peripheral ligament) DISCUSSION: The short follow-up of this series (four years) does not enable an assessment of the risk or benefit of PCL ligamentoplasty for arthrosic knees.

English Abstract↗