Anterior Cruciate Ligament Reconsruction using Tibialis Tendon Allograft: Comparison of the Results according to the Femoral Fixation Methods / 대한정형외과학회잡지

PURPOSE: To compare the clinical stability and function of two femoral fixation methods after arthroscopic anterior cruciate ligament (ACL) reconstruction using fresh-frozen tibialis tendon allograft. MATERIALS AND METHODS: For femoral fixation, endopearl and bioabsorbable interference screw were used in 31 patients (group I) and RIGIDfix(R), in 36 patients (group II). The mean follow-up period was 30 months. The evaluations included Lysholm knee score, 2000 International Knee Documentation Committee (IKDC) subjective knee score, Lachman test, pivot shift test, KT-1000 arthrometer measurement and 2000 IKDC knee examination. RESULTS: Twenty-eight patients (90.3%) in group I and 33 (91.7%) in group II were good or excellent according to the Lysholm score. Twenty-seven patients (87.1%) in group I and 33 (91.7%) in group II had IKDC subjective knee score >70. Thirty patients (96.8%) in group I and 35 (97.2)% in group II had 1+firm end or negative Lachman test. Twenty-seven patients (87.1%) in group I and 35 (97.2%) in group II had a negative pivot shift. Thirty patients (96.8%) in group I and 36 (100%) in group II had <5 mm of difference according to the KT-1000 arthrometer. Twenty-nine patients (93.5%) in group I and 34 (94.4%) in group II were normal or nearly normal according to the 2000 IKDC knee examination. CONCLUSION: ACL reconstruction with fresh-frozen tibialis tendon allograft produced a reliable and predictable outcome after the short-term follow-up. The two methods used for femoral fixation produced similar outcomes.

Early Loosening of Femoral Component after Primary Total Knee Arthroplasty : Report of 4 Cases

The mechanism of the loosening after arthroplasty is considered that micromotion makes a gap between implant and bone, the subsidence of implant and osteolysis around the implant. The loosening of femoral component after total knee arthroplasty(TKA) might be related to the improper support of posterior condylar area, the causes of which may be inaccurate osteotomy, improper cementing technique and poor bone quality, etc. The authors found four cases of flexed displacement and osteolysis around the femoral component after TKA. The types of implant were one case of PS type and three cases of High Flex PS type. Revision arthroplasty was done in three patients who had severe clinical symptoms with diffuse bone loss around the distal femur. We evaluated the mechanism of the early loosening by clinical and radiologic assessment of four patients.