No abstract

Combined ACL and ALL reconstruction was found to be effective in improving subjective and objective outcomes. Nevertheless, these findings were not significantly superior to isolated ACL reconstruction except for the instrumented knee laxity testing results. This might indicate that ALL reconstruction should not be performed routinely for patients undergoing ACL reconstruction.

Extracorporeal shock wave therapy had favorable outcomes in treating coccydynia. The majority of patients had partial relief of their pain and disability following this therapy.

Acute traumatic patellar dislocation is a common injury, and spontaneous reduction may occur at the time of injury or may be reduced at the field of the accident by someone. It may be associated with osteochondral fractures and rupture of medial patellar stabilizers leading to recurrent patellar instability. The aim of this prospective study was to evaluate the outcomes of medial patellofemoral (PF) ligament (MPFL) reconstruction in recurrent traumatic patellar dislocation. Forty-five patients presented with PF instability as a result of traumatic rupture MPFL with normal patellar tracking underwent MPFL reconstruction without patellar fixation hardware through two parallel transpatellar tunnels and one screw in femoral tunnel. All patients were evaluated clinically preoperatively and at a minimum follow-up of 24 months, and International Knee Documentation Committee (IKDC) and Kujala scores were used to assess the clinical results. All patients were available for evaluation at a minimum of 24 months (up to 36 months). The mean age of these patients at the time of surgery was 22.82 years (range: 18–34 years). All patients gave history of trauma of their knees. Mean IKDC scale showed significant improvement as it rose from 47.17 preoperatively to 77.94 postoperatively, and mean Kujala score rose from 53.88 preoperatively to 86.24 postoperatively (p < 0.001). No recurrence of dislocation was recorded. Only three patients had mild atrophy of thigh and one patient had some difficulty in jumping. Reconstruction of MPFL by this method provides good clinical result in the treatment of PF instability by using autologous graft (semitendinosus and gracilis). Less hardware were used with less complications.

Objective: To assess the results of anterior cruciate ligament reconstruction in a group of sports players. Methods: A total of 153 sports players were reviewed 70 months (range 39–84 months) after they had anterior cruciate ligaments reconstruction by autologous patellar tendon graft (K. Lambert intra-articular reconstruction) combined with extra-articular tenodesis using iliotibial band (MacIntosh tenodesis). Results: We found all the patients were able to return to their normal active life and 131 atheletes were able to return to full sports activities, while 21 patients were not able to go back to their sports or had to modify their sports activities. The knees were assessed using Lysholm knee score, Shino grading system and clinical examination for anterior drawer, Lachman and pivot shift signs. The mean Lysholm knee score was 94.9 (range 71–100) while Shino grading for 64 knees was very good, for 68 knees good, and 21 knees fair. None of the patients had poor results. Conclusions: Depending on the type and degree of functional instability, we recommend anterior cruciate ligament reconstruction by autologous tendon graft and in all cases, extra-articular procedures are required.