Mohammad Mehdi Sarzaeem, MD; Mohammad Razi, MD; Farideh Najafi, MD; Mohammad Amin Najafi
Abstract
Background: The gold standard in ACL reconstructions has been the bone–patellar tendon–bone autograftfixed with interference screws. This prospective study, aimed to compare two method of fixation for BPTB grafts: press fit fixation vs. interference screw, over a 12 months follow-up interval.Methods: ...
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Background: The gold standard in ACL reconstructions has been the bone–patellar tendon–bone autograftfixed with interference screws. This prospective study, aimed to compare two method of fixation for BPTB grafts: press fit fixation vs. interference screw, over a 12 months follow-up interval.Methods: In a randomized clinical trial study, 158 patients with an average age of 29.8 years were treated for torn ACL with BPTB autograft in a teaching hospital in Tehran, Iran. In 82 patients press fit fixation technique, and in 76 cases an interference-screw was used. At the time of final follow-up, 71 patients in press-fit group and 65 patients in interference-screw group were evaluated in terms of return to pre-injury activity level, pain, knee stability, range of motion, IKDC score and complications.Results: In the final follow-up, 59 cases in interference screw and 55 in press-fit screw group had good-to-excellent IKDC score (p < /em>≥.05). The mean laxity assessed improved to 2.7 mm and 2.5 mm in press-fit and screw group, respectively. Regarding Lachman and pivot shift tests, there was a statistically significant improvement in the integrity of the ACL in both groups, with no significant difference (p < /em>≥.05).Conclusions: the press-fit technique is an efficient procedure. Its outcome was comparable with the interference screw group. Furthermore it has unlimited bone-to-bone healing, no need for removal of hardware, ease for revision and cost effectiveness.
Mohammad Mahdi Sarzaeem; Mohammad Emami; Mohammad Emami; Gholamhossein Kazemian; Gholamhossein Kazemian; Alireza Manafi Rasi; Mohammad Mahdi Bagherian Lemraski; Farshad Safdari
Abstract
Background: Large defects in chronic Achilles tendon ruptures are difficult to rapair. The purpose of this study was to evaluate the clinical and functional outcomes following reconstruction of the chronic large gaps in Achilles tendon ruture using free semitendinosus interposition tendon grafting. Methods: ...
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Background: Large defects in chronic Achilles tendon ruptures are difficult to rapair. The purpose of this study was to evaluate the clinical and functional outcomes following reconstruction of the chronic large gaps in Achilles tendon ruture using free semitendinosus interposition tendon grafting. Methods: In a case series study, eleven male patients with mean age of 30±4 years and average defect size of 8.31±1.96 cm in their old Achilles tendon underwent reconstruction during 6 years in a teaching hospital in Theran-Iran. Ipsilateral semitendinosus free tendon graft was used for reconstruction. The cases were evaluated by Ankle-Hindfoot Scale of American Orthopaedic Foot and Ankle Society (AOFAS), and the Achilles Tendon Rupture Score (ATRS) to with a mean follow-up of 25.36±3.3 months. Results: The pre-operative AOFAS and ATRS of 70.4±5.3 and 31.7±5.7 preoperatively improved to 91.8±4.8 and 88.7±4.2 values. The ankle dorsiflexion showed a significant decline – postoperative value of 13.5±4.2 degrees compared to preoperative of 17.2±3.9 degrees (p=.04). All the cases except a professional athlete, returned to their previous activities. Conclusion: This technique offers good clinical and functional results in patients with large defects and is associated with no donnersite morbidity. We recommend this technique for the reconstruction of the chronic at ruptures in patients with over 6 cm defects.
