Second-Look Arthroscopy after ACL Reconstruction: Comparison of Patellar Tendon Autografts with Hamstring Tendon Autografts / 대한정형외과학회잡지

PURPOSE: To evaluate the healing status of reconstructed anterior cruciate ligament (ACL) and meniscal repair through second-look arthroscopy after arthroscopic reconstruction of the ACL. MATERIALS AND METHODS: We analyzed 81 cases by second-look arthroscopy among 397 cases that received ACL reconstruction during the period from June 1996 to December 2000. Second-look arthroscopy was conducted on average 18.8 months after reconstruction. 53 cases received a patellar tendon autograft, 28 cases received a hamstring tendon autograft and 29 cases received meniscal repair. We measured graft tension using displacement by probing, and synovial coverage by visual analysis at second-look arthroscopy. The improvements in Lysholm knee scores and KT-2000 arthrometer results were evaluated to compare patellar and hamstring tendons. RESULTS: The patellar tendon group showed normal tension in 41 cases and lax tension in 12 cases. The hamstring tendon group showed normal tension in 22 cases and lax tension in 6 cases. In the patellar tendon group, synovial coverage was good in 38 cases, half in 4 cases, and pale in 11 cases, whereas the hamstring tendon group was good in 25 cases, half in 2 cases, and pale in 1 case. Synovial coverage was better in the hamstring tendon group (p<0.05). Although there was no statistical significance, the hamstring tendon group was superior to the patellar tendon group in terms of graft tension, Lysholm knee scores and KT-2000 arthrometer results. CONCLUSION: The hamstring tendon group with ACL reconstruction was superior to the patellar tendon group, but long term follow-up will be necessary to further evaluate results.

Origins of Dorsal Root Ganglion Cells with CGRP innervating Quadriceps Femoris Tendon of Rat / 대한정형외과학회잡지

PURPOSE: This study was undertaken to determine the origins of dorsal root ganglion (DRG) cells containing calcitonin gene-related peptide (CGRP) which innervate the quadriceps femoris tendon in the rat. MATERIALS AND METHODS: DRG cells containing CGRP, which innervate the quadriceps femoris tendon, from 25 rats (Sprague-Dawley, 200-250 g) were examined using the retrograde tracing technique (neural tracers: horseradish peroxidase and fluorogold) combined with immunohistochemistry. RESULTS: Injection of horseradish peroxidase (HRP) or fluoro-gold (FG) into the quadriceps femoris tendon resulted in the ipsilaterally labelling of cells between L1 and L6 DRGs. However, a large number of the labelled cells innervating the quadriceps femoris tendon were found in the L3 and L4 DRGs. Many DRG cells were immunostained with CGRP antibody in the L1-6 DRGs. The number of CGRP immunoreactive cells in the lumbar DRGs was larger than in the sacral DRG. FG labelled cells containing CGRP immunoreactivity (FG+CGRP cells) were found in the lumbosacral DRGs. Many FG+CGRP cells innervating the quadriceps femoris tendon were located in the L3 and L4 DRGs. CONCLUSION: These results show that the main DRG origin for the sensory innervation of the quadriceps femoris tendon is L3 or L4. The neurogenic pain of the quadriceps femoris tendon may originate from this region, and suggests that this may be important for the release of neurogenic pain.

Arthroscopic Reduction and Pull-out Suture in the Treatment of Fractures of the Intercondylar Eminence of the Tibia

No Abstract Available.

Radiologic Results of Posterior Lumbosacral Fixation according to Sacral Fixation Methods: Single Screw vs Double Screws / 대한척추외과학회지

STUDY DESIGN: This is a retrospective study comparing the radiologic results of sacral fixation using anteromedially directedsingle screw and triangulated double sacral screws. OBJECTIVES: To know whether the single screw fixation is enough for short level lumbosacral fusion. SUMMARY OF LITERATURE REVIEW: Method of sacral fixation is one of a hot issue in spinal instrumentation because of high complication rate. So, many kinds of sacral fixation methods were developed for long level spinal instrumentation. But, it is unclear whether we should use the special sacral fixation techniques instead of simple single screw fixation for the short level lumbosacral fusion. MATERIALS AND METHODS: Inclusion criteria of this study were fixation down to sacrum or sacralized L5, less than three segments fixation and minimum radiologic follow-up for one year. Of those patients treated with lumbosacral fixation using pedicle screw instrumentation from March 1989 to June 1998, forty-four patients met these criteria. They were divided into two groups according to the method of sacral fixation, Group I for single screw fixation and Group II for double screw fixation. Number of patients were 37 in Group I and 7 in Group II. The mean follow-up was 36.5 and 66.6 months, respectively. The radiologic results were evaluated by metal failure, change of lumbar lordosis, change of lumbosacral angle and change of L5-S1 disc space height. RESULTS: metal failure were identified in five patients(13.5%), all in sacral screws of Group I. There were 4 screw breakages and 1 screwrod dissociation. The change of lumbar lordosis was averaged 2.3 degrees(-17~38) in Group I and -4.0 degrees(-25~17) in Group II(p=0.194). The change of lumbosacral angle was averaged 2.3 degrees(-7~12) and 3.7 degrees(-1~12), respectively(p=0.596). The change of disc height was 5.6%(-13~33) and 8.8%(-5~16), respectively(p=0.381). CONCLUSIONS: Group I has much higher rate of instrumentation failure than Group II and all the instrumentation failures were occured at sacral screws. Other radiologic measurements were not statistically significant between the two groups. Stable fixation of the sacrum is necessary to prevent instrumentation failure at the sacrum even though the fusion is less than three levels.