摘要:

Reconstruction of the anterior cruciate ligament with hamstring tendon autografts is a well accepted procedure which involves a relatively low morbidity rate. Complications can occur; they are divided into those occurring with graft harvest, with graft placement and fixation, at the donor site, and with the implanted graft. This article discusses these potential complications and provides tips for avoiding them.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

This paper reviews the treatment for symptomatic combined Grade III anterior cruciate ligament (ACL) and posterolateral knee injuries. Due to the high failure rate of ACL reconstructions when injuries to the posterolateral corner are neglected, it is recommended that reconstruction of an acute posterolateral knee complex injury be performed at the time of the acute ACL reconstruction to reduce the chance of ACL reconstruction failure. Treatment options for reconstruction of chronic Grade III posterolateral complex and ACL injuries are more complex and are also reviewed here. The results of combined ACL and posterolateral corner reconstructions in chronic cases are still preliminary, and further research is necessary to determine the optimal method of reconstruction in these cases.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The management of medial compartment gonarthrosis and anterior cruciate ligament instability should first focus on addressing the patient's primary complaint. Symptoms related to joint arthrosis are typically addressed initially, and then instability if symptoms persist after treatment of the gonarthrosis. The purpose of this article is to review and discuss the management of the patient with medial compartment gonarthrosis and anterior cruciate ligament insufficiency.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Nonosseus disruptions of the anterior cruciate ligament in children may be on the rise. Anterior cruciate ligament (ACL) disruptions in the pediatric age group were thought previously to have a benign natural history, but recent reports suggest that these injuries may result in significant functional instability and further injury to the knee. These possible consequences have led to a more aggressive approach to the pediatric athlete presenting with an unstable ACL-deficient knee.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Allogeneic tendons are useful human tissues for reconstructing ligaments, including the anterior cruciate ligament. This article offers some summaries of scientific background on ACL reconstruction with allogeneic tissue in animals, clinical follow-up in the human knee, including second-look arthroscopy and results of histologic evaluations by light and electron microscopy, suggestions on allograft ACL reconstruction, and discussions on secondary sterilization to prevent disease transmission.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The menisci serve important functions in the normal knee. These functions include: assisting in load transfer, shock absorption, joint stability, and joint lubrication. Despite an increased awareness of these functions, and of the deleterious effects of meniscectomy, meniscectomy is often still necessary. Thus, the management of the painful, post-meniscectomy knee continues to challenge orthopaedic surgeons. Meniscal allograft transplantation was developed in an attempt to prevent the progressive deterioration that occurs following meniscectomy. Proper treatment requires an assessment of the patient's activity level, disability, associated injuries, and degree of arthrosis and deformity. Surgeons should be familiar with the various methods of allograft tissue banking and their potential effects on allograft function, disease transmission, and cost. Most current clinical reports of meniscal transplantation are limited to short-term evaluation of heterogeneous patient populations and techniques. As such, although meniscal transplantation remains a cautiously optimistic treatment for the future, at present it should be considered a salvage procedure in the treatment of the painful, early arthritic knee following meniscectomy.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Revision ACL surgery is sure to become more common as the numbers of primary ACL reconstruction increase, due to recurring trauma or failures from technical problems. Special attention to the causes of graft failure is important, because technical errors in tunnel placement, graft fixation, progressive loss of bone and other areas can be corrected. Repetitions of treatment errors must be avoided. The choice of tissues (allografts, ligament protheses, etc.) is also a major point for the long-term outcome after revision ACL surgery. The ability to resume a top level sporting activity must be considered realistically by both surgeon and patient.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

The senior author developed this single-incision arthroscopic-assisted procedure for patellar tendon graft reconstruction of the anterior cruciate ligament nearly 10 years ago. Over time, we have been able to obtain consistently good results. The advances of this procedure include safety with graft harvest and reduction in patient morbidity, allowing patients to return to their desired activity level with near-normal knee stability and strength. The success of this operation depends on the surgeon's systematic completion of each step and the use of intraoperative radiographs before moving on to the next step.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Articular cartilage lesions can occur with the trauma of anterior cruciate ligament (ACL) rupture, but they increase in incidence and severity with the passage of time. Acute articular cartilage defects are difficult to diagnose and are often obscured by the ACL injury. Arthroscopy is the “gold standard” for diagnosis; improving MRI technology offers the best noninvasive method. Bone scans and weight-bearing and alignment x-rays may confirm chronic degenerative changes. Acute osteochondral fractures are more common in children, while full-or-partial-thickness lesions are more common in mature articular cartilage. Articular cartilage has a limited potential to heal unless the subchondral bone is penetrated. Partial-thickness lesions evoke no healing response but rarely progress. Current techniques to promote repairative tissue-drilling or abrasion-rarely restore a normal joint surface; no current replacement of articular cartilage duplicates its material properties or durability.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID

摘要:

Although most athletic injuires appear to be related to the nature of the particular sport rather than to the sex of the athlete, recent studies have shown a significantly higher rate of anterior cruciate ligament (ACL) injuries in women participating in certain sports (soccer, basketball, gymnastics, team handball, volleyball, and alpine skiing) than in men in the same sports. Many theories have been advanced to explain the increased rate of ACL injuries among women, including shoe-surface interface, muscle strength and function, sports skills, joint anatomy and the dimensions of the intercondylar notch, and cyclical hormone effects. No matter what the cause of the ACL injury is, whether its treatment is nonoperative or operative should depend not on the athlete's sex, but on the athlete's age, severity of injury, and work, athletic, and lifestyle concerns.

ISSN:1062-8592    

出版商:OVID    

年代:1997

数据来源: OVID