III.

No abstract

We recommend triple pelvic osteotomy for patients with LCP when conservative methods are not successful. According to our results we believe that Waldenstrom classification is a better option than Herring classification to determine the prognosis of disease after containment surgery.

PurposeTo investigate the effect of preoperative coronal tibiofemoral subluxation (CTFS) on functional outcome, prosthesis type, insert thickness and revision rates in patients who underwent total knee arthroplasty (TKA). MethodsA total of 224 knees of 186 patients were included. Patients were divided into two groups as either with (Group 1, 114 knees of 86 patients) or without (Group 2, 124 knees of 100 patients) coronal lateral tibiofemoral subluxation. The mean follow‐up period was 71.3 ± 7.3 (range 60–84) months in group 1 and 69.4 ± 6.6 (range 61–79) months in group 2 (n.s.). Coronal tibiofemoral subluxation degree was measured in degrees on standing anteroposterior knee radiographs. Group 1 was divided into three subgroups according to amount of subluxation (< 5 mm, 6–10 mm and > 10 mm). Functional outcome was evaluated using the Western Ontario and McMaster Osteoarthritis Index (WOMAC) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at the last follow‐up visit. Prosthesis type, insert thickness and revision rates were compared between the two groups. ResultsThere were no significant differences between the two groups regarding patient demographics, prosthesis type, and revision rates (n.s.). The insert thickness was found significantly higher in group 1 (p < 0.001). The preoperative and postoperative WOMAC and KOOS scores were found no significantly different between the two groups (n.s.). Among subluxation (+) subgroups, there was no significant difference in functional outcome scores and revision rates (n.s.). However, prosthesis type and insert thickness were significantly associated with the amount of subluxation (p = 0.009 and p = 0.001, respectively). There was no significant correlation between the degree of lower extremity deformity and coronal tibiofemoral amount of subluxation (n.s.). ConclusionPreoperative CTFS does not adversely affect the WOMAC score, KOOS and revision rates after TKA. In the clinical practice, surgeons should be aware of the need for a posterior cruciate stabilizing prosthesis and a thicker insert in the presence of CTFS, especially with subluxation greater than 10 mm and to consider a spared bony resection on the tibia in patients suffering from CTFS. Level of evidenceIV.

Knee ligament injuries are among the most frequently encountered injuries. [1,2] Although different types of surgical techniques with excellent clinical results have been reported for the reconstruction of a ruptured anterior cruciate ligament (ACL), graft selection is still a controversial issue. Every particular graft type Amaç: Bu çalışmada, iki otojen greft türünün kullanımına ilişkin orta dönem klinik sonuçlar değerlendirildi. Hastalar ve yöntemler: Haziran 2005 -Kasım 2010 tarihleri arasında ameliyat edilen 44 hastanın klinik verileri retrospektif olarak incelendi. Onarım cerrahisi için 23 hastada (QT-PB grubu) kuadriseps tendon-patella kemiği otogrefti, 21 hastada (HT grubu) ise dört katlı hamstring tendon otogrefti kullanıldı. Veri toplamada Tegner aktivite skalası, Lysholm skorlama sistemi, tek bacak sıçrama testi ve KT-2000 artrometrik ölçümleri kullanıldı. Bulgular: Ortalama takip süresi 37.6 aydı. Ortalama Lysholm skoru her iki grupta da artmasına rağmen, HT grubunda elde edilen mükemmel sonuçlar QT-PB grubundakinin iki katı kadardı. Ortalama laksite miktarı QT-PB grubunda 5.65 mm (3.5-8.0 mm) iken HT grubunda 3.67 mm (3.0-5.5 mm) olarak ölçüldü. KT-2000 artrometre kullanıla-rak yapılan bire bir analizde QT-PB grubunda 12 hastada (%52.1) ve HT grubunda iki hastada (%9.6) 3 mm'den fazla ön laksite farkı saptandı. Sonuç: Artroskopik ön çapraz bağ onarım cerrahisinde dört katlı hamstring tendon otogrefti, santral kuadriseps tendonpatella kemiği otogreftinden üstündür.Anahtar sözcükler: Ön çapraz bağ onarımı; ön çapraz bağ; artroskopi; kuadriseps kası; tendon.Objectives: This study aims to evaluate midterm clinical results of the use of two autogenous graft types. Patients and methods: Between June 2005 and November 2010, clinical data of 44 patients who were operated were retrospectively analyzed. Quadriceps tendon-patellar bone autograft was used for reconstruction surgery in 23 patients (QT-PB group), while quadrupled hamstring tendon autograft was used in 21 patients (HT group). The Tegner's activity scale, Lysholm scoring system, single-leg-hop test and KT-2000 arthrometric measurements were used for data collection. Results: The mean length of follow-up was 37.6 months. Although the mean Lysholm score increased in both groups, excellent results in HT group were two-fold higher compared to QT-PB group. The mean laxity for the operated knee joint was 5.65 mm (3.5 to 8.0 mm) in QT-PB group and 3.67 mm (3.0 to 5.5 mm) in HT group. Head-to-head analysis using KT-2000 arthrometer demonstrated that 12 patients (52.1%) in QT-PB group and two patients (9.6%) in HT group had more than 3 mm of anterior laxity difference. Conclusion: Quadrupled hamstring tendon autograft is superior to central quadriceps tendon-patellar bone in arthroscopic anterior cruciate ligament reconstruction surgery.