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  • Articles: DFG German National Licenses  (2)
  • Extra-articular reconstruction  (1)
  • Patellar dislocation  (1)
  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Knee surgery, sports traumatology, arthroscopy 3 (1995), S. 163-166 
    ISSN: 1433-7347
    Keywords: Knee ; Surgical technique ; Patellar dislocation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract The authors compare the clinical and radiographic outcome in patients with comparable bilateral recurrent patellar dislocation treated surgically on only one side, to clarify the appropriateness of the surgical indication. Sixteen patients were evaluated at an average follow-up of 30 years (20–45); all had been treated by the Roux technique. The results on both the operated and the unoperated knee were evaluated; the Crosby and Insall schedule was used for the clinical evaluation. Anteroposterior, lateral, and Merchant's view X-rays were examined for osteoarthritis and to measure the height of the patella. The congruence angle and the distance between anterior tibial tuberosity and trochlear groove (ATT-TG) were measured by computed tomography. The results in the operated knees were: 3 excellent, 9 good, 1 fair, and 3 worse; results in the nonoperated knees were 6 excellent, 8 good, 1 fair, and 1 worse. In the operated knees arthritis was grossly marked in 8, marked in 3, moderate in 1, and light in 4; in the nonoperated ones it was grossly marked in 8, moderate in 3, and light in 5. The congruence angle was normal in 10, medially displaced in 3, and laterally displaced in 3 cases on the operated side; on the nonoperated side it was normal in 7 cases and lateralized in the remaining 9. The ATT-TG in the operated knees was negative in 9 cases, normal in 1, and positive in 6; on the nonoperated side it was positive or normal. In 7 operated cases a low patella was documented. The Roux technique yields positive results in the correction of recurrent dislocation. No clinical or radiographic differences were found between surgically and conservatively treated knees. The clinical results are generally not comparable with the radiographic features or with severity of degenerative modifications presented at long-term follow-up. The absence of a difference is due basically to the complete lack of adaptation of the surgical procedure to the variable pathogenesis of this disorder.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1433-7347
    Keywords: Key words Arthroscopy ; Anterior cruciate ligament reconstruction ; Hamstrings ; Extra-articular reconstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Sports Science
    Notes: Abstract Numerous surgical procedures have been developed and used for anterior cruciate ligament (ACL) reconstruction. Patellar tendon is probably the most common graft used, but gracilis and semitendinous tendons present some interesting advantages: small incision, large graft when doubled, characteristics close to ACL, rapid harvest. We describe a combined intra- and extra-articular arthroscopic ACL reconstruction using hamstring tendons which includes some original steps. The tendons are harvested, leaving the distal insertion intact, and sutured together. After drilling of the tibial tunnel, an over-the-top arrangement is formed, creating a groove in the posterolateral aspect of the femur. The tendons are then fixed with double staples in the groove, and their remaining part is fixed distally to Gerdy’s tubercle passing under the fascia, but over the lateral collateral ligament (LCL). This technique ensures sufficient strength in the graft and permits correction of any associated instability, because of the presence of the extra-articular portion of the tendons. Furthermore, the over-the-top arrangement reduces trauma and possible pitfalls related to tunnel construction and permits isometry of the extra-articular portion to be established. Forty patients involved in sports activity were prospectively selected and evaluated at a minimum 2 years’ follow-up. IKDC score and Lysholm score were used for clinical evaluation, and the KT-2000 was used for instrumental laxity measurements. Resumption of sport and time to that point were recorded as well as Tegner activity score. We had 92.5% normal and fairly normal knees according to IKDC score and only 7.5% abnormal knees. Mean Lysholm score was 95. Mean Tegner score was 7.2. KT-2000 showed a mean injured/uninjured difference of 2.1 mm. In all, 90% of patients resumed sports at the same level, 67.5% in 3–4 months and 27.5% in 4–6 months. The highly satisfactory results of this series with no major complications confirm the reliability of this techinque and the possibility of guaranteeing functional behaviour in the knee.
    Type of Medium: Electronic Resource
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