Azin Zargham; Karim Leilnahari; Soheil Mehdipoor; Elnaz Nouri; Sohrab Keihani
Abstract
Background: Anterior cruciate ligament (ACL) tear is a common injury in sports. Different technigues for reconstruction of this ligament have been suggested. This paper compares the knee kinematics between "single bundle" and "double bundle" ACL reconstruction with hamstring tendon in a computerized ...
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Background: Anterior cruciate ligament (ACL) tear is a common injury in sports. Different technigues for reconstruction of this ligament have been suggested. This paper compares the knee kinematics between "single bundle" and "double bundle" ACL reconstruction with hamstring tendon in a computerized knee model. Methods: A computer-knee modle was constructed. Then "single bundle" and "double bundle" ACL reconstruction was performed. The knee stability and ligament tension were tested in 3 different settings: 1) At 30° knee flexion under isolated postero-anterior load, valgus and rotational torque was applied, 2) In weight-bearing flexion range (from extension to 70° of flexion) an anterior load of 134 Newton was applied, 3) Knee model was loaded by a non-contact pivot farce to produce ACL rupture. Results: The results showed no significant difference between "single bundle" and "double bundle" under isolated loading. The second and third model, however, showed 4 times greater tension on the ligament in "single bundle". The "single bundle" in the second technique of testing (weight bearing) showed at most 7 mm more displacement compared with "double bundle". In the third testing technique "double bundle" was stronger than "single bundle" in valgus torque resistance. The internal rotation stability was also more in "double bundle". Conclusion: Functional stability of knee model of ACL reconstruction with a "double bundle" graft is superior to a "single bundle" graft.
Sohrab Keyhani, MD; Seyyed Reza Sharifzadeh, MD; Mohammad Reza Abbasian, MD; Touraj Shafaghi, MD; Soheil Mehdipour, MD; Farshad Safdari, MSc
Abstract
Background: The purpose of this study was to evaluate the functional outcome of arthroscopic treatment of chondral and osteochondral lesions of the knee with arthroscopic osteochondral autograft transfer (Mosaicplasty), and to evaluate the factors affecting the treatment outcome.Methods: In a before ...
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Background: The purpose of this study was to evaluate the functional outcome of arthroscopic treatment of chondral and osteochondral lesions of the knee with arthroscopic osteochondral autograft transfer (Mosaicplasty), and to evaluate the factors affecting the treatment outcome.Methods: In a before and after clinical trial, 56 patients with grade 4 full thickness chondral lesion (outer bridge classification) were treated by the arthroscopic mosaicplasty technique over a 4-year period at an hospital in Tehran, Iran. The mean time of follow-up was 21±4 months (16-32 months). The patients were assessed by International Knee Documentation Committee (IKDC) and Lyshom knee scoring scale (LKSS). The impact of age, site of chondral lesion (medial or lateral femoral condyle), extent of the lesion (number of plugs) and associated lesions, preoperative active levels, tourniquet time and surgery complications were studied. In 3 cases, second-look arthroscopy was performed.Results: The result of 78.6% was excellent and 21.4 good, based on IKDC. Preoperative Lysholm score was 67.1±17.6 and postoperative score increased to 93.2±6.5 (p < /em>=.0004). Clinical outcomes were better significantly in patients with associated articular lesions, lateral condyles lesions, professional athletes and younger patients, also in cases with lower plug numbers and sport injuries (p < /em>
