PRP on Prevention of Tunnel Enlargement in ACL Reconstruction.

BACKGROUND: The purpose of this study is to describe the role of Platelet Rich Plasma in preventing tunnel enlargement in anterior cruciate ligament reconstruction with a hamstring autograft Material and methods. Forty-four patients who underwent transtibial reconstructive surgery with a hamstring tendon autograft between March 2014 and July 2015 were included in this study. This study involved two groups. Group A consisted of 18 patients who underwent PRPadministration into the femoral and tibial tunnel. Group B was a control group that included 26 patients who underwent ACL reconstruction surgery with a hamstring autograft without PRP. The patients were evaluated preoperatively and postoperatively with the IKDC score, Lysholm score, Tegner activity scale and a KT-1000 arthrometer device. The diameter of the tibial and femoral tunnels of the operated knees was measured on the first day and at three months postoperatively using CT. Measurements carried out for tomography standardization of the patients were evaluated on coronal, sagittal and axial images from 64-slice MSCT scans. RESULTS: On comparison of radiological data between both groups, there was less tunnel enlargement in PRP-administered group for the femoral tunnel, but the result was not statistically significant. No difference was seen between clinical examination results and the grading scales used. CONCLUSIONS: 1. The radiological findings of our study indicated that while there was less tunnel enlargement in the PRP group, there was no statistically significant difference between the groups. 2. Similarly, clinical exa-mination results and scoring scales used did not de-monstrate any intergroup difference. 3. As a result, we donot recommend routine use of PRP for the prevention of tunnel enlargement after ACL reconstruction.

Arthroscopic Management and Treatment of Synovial Chondromatosis and Talus Osteochondral Defect in the Ankle Joint. A Case Study.

Synovial chondromatosis has an unknown aetiology and is a benign lesion especially seen in joints like the knee and hip. However, it is extremely rare in the ankle joint. A review of the literature shows that ankle joint chondromatosis is usually treated by arthrotomy. However, excision of loose bodies by arthroscopy in the ankle joint is not common. Arthroscopic surgery provides a wide visualisation area for excision of loose bodies, allowing for synovectomy and microfracture. Our patient was a 60-year-old female who presented to our clinic with primary osteochondromatosis and osteochondral defect. Our patient underwent arthroscopic excision of loose bodies, microfracture and synovectomy. Arthroscopic management can be successful in selected patients with synovial osteochondromatosis localized to the ankle joint.

Which is the best fixation method for lateral cortex disruption in the medial open wedge high tibial osteotomy? A biomechanical study.

When performing a medial opening wedge upper tibial osteotomy, a fracture into the lateral cortex can lead to loss of stability of the construct. The aim of this study was to assess different intra-operative techniques to overcome this problem, and test the stability under axial compression. Twenty eight calf tibias had a medial opening wedge osteotomy and lateral cortical fracture created and then were tested in four groups depending on how this fracture was fixed; none, a plate and screws, two staples, and a circular external fixator. Loss of medial height of the osteotomy line and lateral cortex micromotion was evaluated under maximal axial loading of 2,500 N. No fixation had significantly inferior results compared with the other three types. The plate and screws and staples showed better results than circular external fixation in terms of preserving the medial height, whereas the plate and screws and circular external fixator showed better results compared with staples in terms of lateral cortex stability. This study suggests that plate and screw fixation for lateral cortex disruption during the medial opening wedge upper tibial osteotomy has better stability under axial compression than staples or a circular external fixator.