Background:Grade 3 Posterior Cruciate Ligament (PCL) injury needs surgical intervention, but there is no consensus on the optimal technique in PCL reconstruction. The old technique always removes the remnant for good visualization of tunnel replacement. Recently, many studies proposed the concept of the preservation of PCL remnant with achieving good visualization. The aim of the study is to evaluate PCL reconstruction with remnant preservation using the standard anterior and posteromedial portal at 2-years follow-up. Methods:We conducted a cohort retrospective study between January 2013 to December 2015. In this study, 25 patients underwent PCL reconstruction using standard anterior and posteromedial portal with remnant preservation. We used quadrupled hamstring autograft. The patients were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm knee score, Modified Cincinnati Score, and Knee Society Score (KSS) at pre-operative and 2-years post-operative. Range of Motion (ROM) and complication were evaluated post-operatively. Results:The mean diameter of the quadruple hamstring graft was 8 mm. Clinical outcomes enhanced significantly (p<0.05). The average Lysholm activity scale improved from 65.12 ± 10.48 to 94.96 ± 4.80. The International Knee Documentation Committee (IKDC) score improved from 60.50 ± 15.10 to 95.60 ± 3.44. The Modified Cincinnati Score improved from 62. 28 ± 13.6 to 96,04 ± 1.62. The KSS also improved from 60.12 ± 18.01 to 94.88 ± 6.36. 22 patients had 0-135° full ROM and 3 patients had 0-110° ROM. Two patients had surgical site infection but recovered with local debridement. Conclusion:PCL reconstruction using standard anterior and posteromedial portal with remnant preservation at 2 years follow up resulted in satisfactory clinical and functional outcomes.

BACKGROUND: Grade 3 posterior cruciate ligament (PCL) injury needs surgical intervention, but there is no consensus on the optimal technique in PCL reconstruction. The old technique always removes the remnant for good visualization of tunnel replacement. Recently, many studies proposed the concept of preservation of PCL remnant with achieve good visualization. AIM: The aim of the study is to evaluate PCL reconstruction with remnant preservation using the standard anterior and posteromedial portal at 2-year follow-up. METHODS: We conducted a cohort retrospective study between January 2013 and December 2015. In this study, 25 patients underwent PCL reconstruction using the standard anterior and posteromedial portal with remnant preservation. We used quadrupled hamstring autograft. The patients were assessed using the International Knee Documentation Committee (IKDC) score, Lysholm Knee Score, Modified Cincinnati Score, and knee society score (KSS) at pre-operative and 2-year post-operative. Range of motion (ROM) and complications were evaluated postoperatively. RESULTS: The mean diameter of the quadruple hamstring graft was 8 mm. Clinical outcomes enhanced significantly (p < 0.05). The average of Lysholm activity scale improved from 65.12 ± 10.48 to 94.96 ± 4.80. The IKDC score improved from 60.50 ± 15.10 to 95.60 ± 3.44. Modified Cincinnati score improved from 62. 28 ± 13.6 to 96.04 ± 1.62. The KSS also improved from 60.12 ± 18.01 to 94.88 ± 6.36. Twenty-two patients had 0–135° full ROM and three patients had 0–110° ROM. Two patients had surgical site infection but recovered with local debridement. CONCLUSION: PCL reconstruction using the standard anterior and posteromedial portal with remnant preservation at 2-year follow-up resulted in satisfactory clinical and functional outcomes.

Background: Discoid meniscus is a rare entity of knee pathology. The discoid meniscus can be encountered incidentally during a treatment of another knee pathology as an asymptomatic entity or can be a symptomatic pathology which warrant treatment Case presentation: There were 8 cases of symptomatic discoid meniscus reported in this retrospective case series. The symptoms presented at age range 16-47 year-old. Majority of the case (6 of 8) are lateral discoid meniscus with female gender predominant. Complete type of discoid meniscus was also found in 6 of 8 cases. There were 5 cases of ruptured discoid meniscus, three of them needed repair.  Conclusions: Symptomatic discoid meniscus can be presented on wide range of age of patients. We found female gender, discoid lateral meniscus, and complete type are the predominant pattern of discoid meniscus cases presentation.

A 74-year-old male with alkaptonuria (AKU) was admitted to the emergency department with left distal femur pain and Rorabeck type 2 periprosthetic femur fracture following total knee arthroplasty (TKA). AKU is an autosomal recessive disorder characterized by homogentisic acid buildup in connective tissues and joints, leading to ochronosis and arthritis. Multiple joint replacements are common in AKU patients, and periprosthetic fractures may occur due to osteopenia. Rorabeck type 2 fracture is treated with intramedullary nailing or locked plating. The patient underwent internal fixation with locking plate and bone grafts using minimally invasive plate osteosynthesis (MIPO) procedure, resulting in good fracture healing. The case highlights the importance of considering AKU as a differential diagnosis in arthritis patients and managing periprosthetic fractures with care in AKU patients.