共查询到20条相似文献,搜索用时 31 毫秒
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The double-row technique is a new concept for arthroscopic treatment of bony Bankart lesion in shoulder instability. It presents
a new and reproducible technique for arthroscopic fixation of bony Bankart fragments with suture anchors. This technique creates
double-mattress sutures which compress the fragment against its bone bed and restores better bony anatomy of the anterior
glenoid rim with stable and non-tilting fixation that may improve healing. 相似文献
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Biomechanical evaluation of a new cross-pin technique for the fixation of different sized bone–patellar tendon–bone grafts 总被引:1,自引:1,他引:0
Thore?Zantop Barbara?Welbers Andre?Weimann Markus?Rümmler Jürgen?Hedderich Volker?Musahl Wolf?Petersen
To overcome the disadvantages of interference-screw fixation of bone–patellar tendon–bone (BPTB) grafts, new fixation techniques for anterior cruciate ligament (ACL) grafts using biodegradable pins have been developed. The hypothesis of the present study was that cross-pin fixation techniques provide a primary stability that is comparable to that of interference screws. A biomechanical in vitro study was discussed. Human BPTB grafts of 8, 9 and 10 mm diameter were fixed in bovine knees with biodegradable cross pins (diameter: 2.0, 2.7 or 3.2 mm) or biodegradable interference screws. Stiffness and ultimate load were evaluated. For 9 and 10 mm BPTB grafts, no statistically significant difference in maximum load and stiffness was found between the four fixation techniques tested. For 8 mm bone blocks the maximum load of the 3.2 mm pins (274.2 N) was significantly lower than for the 2.0 mm pins (479.8 N) and the interference screws (504.0 N). Predominant failure mode in this group was bone-block fracture. Thicker grafts (9 and 10 mm) fixed with the 2.0 mm pins predominantly failed by implant fracture. Femoral fixation of 8, 9 and 10 mm BPTB grafts using cross pins leads to biomechanical properties that are comparable to biodegradable interference screws when tested by a single-cycle load to failure. Cross pins provide a rigid fixation for 9 and 10 mm BPTB grafts. 相似文献
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Tensile properties of an anterior cruciate ligament graft after bone–patellar tendon–bone press-fit fixation 总被引:5,自引:3,他引:2
Volker?Musahl Steven?D.?Abramowitch Mary?T.?Gabriel Richard?E.?Debski Peter?Hertel Freddie?H.?Fu Savio?L-Y.?Woo
Hardware used for fixation of ACL autografts in bone tunnels frequently complicates revision surgery, requiring two-stage procedures when a bone-patellar tendon-bone (B-PT-B) autograft is used for ACL reconstruction. Therefore alternative procedures that eliminate hardware have been advocated. This study compared the mechanical behavior of two fixation procedures: a widely used interference screw (IFS) fixation and a press-fit fixation that is hardware free. Twenty hind limbs from skeletally mature Saanen breed goats were used in this study, ten each in IFS and press-fit groups. After ACL reconstruction the specimens were dissected, leaving a femur-ACL graft-tibia complex (FATC) for uniaxial tensile testing. The tests included a series of three cyclic creep tests (C1-C3) for the evaluation of residual elongation followed by a tensile load to failure test to obtain linear stiffness and ultimate load of the FATCs. Four of ten specimens failed during the cyclic creep test for the press-fit group, compared to one for the IFS group. For the remaining specimens residual elongation following three cyclic creep tests (C1-C3) was 1.7+/-0.5 mm in the press-fit group compared to 1.3+/-0.6 mm in the IFS group, and there was no statistical significant difference between the two fixations. In the load to failure test there was also no statistical significant difference in linear stiffness between the two fixations. However, the ultimate load for the press-fit group (215+/-75 N) was significantly lower than that for the IFS group (328+/-103 N). These results provide the basis for future studies involving the time course of healing of these two procedures using the goat model. 相似文献
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We studied arthroscopic reconstruction of the anterior cruciate ligament (ACL) using patellar ligament-bone graft fixed to the femur by press-fit technique. The main feature of this technique was a stable bony fixation on the femoral site without using interference screws or other fixation devices. We treated 42 patients with ACL rupture by this technique; clinical examination was carried out preoperatively and at 3 months, 6 months, and then every 6 months using the standard criteria for evaluation of the IKDC (mean follow-up 29 months, 22–41). CT and MRI were performed 6 months postoperatively. According to IKDC score 37 knee (88%) were graded as normal or nearly normal, 4 (10%) as abnormal, and one (2%) as severely abnormal, none of the poor results was due to instability. Reconstruction of the ACL by press-fit technique is a more anatomically oriented method of fixation without the complications of interference screws at the femoral attachment of the graft. 相似文献
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The advantages of circular external fixation used in high tibial osteotomy (average 6 years follow-up) 总被引:6,自引:5,他引:1
We evaluated the midterm results of high tibial osteotomy in patients with medial compartment arthritis. This study included 53 patients treated with high tibial osteotomy accompanied by either internal fixation (group A, n=26) or Ilizarov-type external fixator (group B, n=27). Clinical assessment of patients was performed using Hospital of Special Surgery scoring. Radiography was based on orientation angles of the knee (medial proximal tibial angle, lateral distal femoral angle, posterior proximal tibial angle) and mechanic axis alignment test. We used the Insall-Salvati index to determine patellar height. The mean follow-up in group A was 77 months (range 63-118) and that in group B 72 months (range 61-113). The patients of group B demonstrated better results in terms of Hospital of Special Surgery score, alignment of lower extremity, and preventing of progression of arthritis. We believe that normal alignment and orientation of the knee could be precisely established with a circular external fixator, and that some disadvantages such as patella infera, failed correction, and loss of bone in proximal tibia as observed after classic high tibial osteotomy can be avoided. Furthermore, progression of arthritis can be prevented if the mechanical axis passes through the lateral compartment of the knee. 相似文献
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We present a case of percutaneous fixation of a “carrot-stick” spinal fracture in an elderly patient with ankylosing spondylitis (AS). A surgical stabilization was not possible in this 83-year-old man with comorbidities. Under local anesthesia, percutaneous screw fixation of a transdiscal shear fracture at the level T10-T11 was performed using computed tomography (CT) and fluoroscopy guidance. Two 4.0-mm Asnis III cannulated screws were placed to fix facet joints using transfacet pedicle pathway. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 10, preoperatively, to 1 after the procedure. Radiographic fusion was observed at a 3-month post-procedural CT scan. CT- and fluoroscopy-guided percutaneous screw fixation of spinal fractures could potentially be an alternative to surgery in elderly AS patients with poor performance status. 相似文献
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Purpose
We evaluated with magnetic resonance imaging (MRI) the degradation and osteointegration features of a new type of bioabsorbable interference (BioRCI) screw composed of poly-L-lactic acid and hydroxyapatite (PLLA-HA) used for tibial graft fixation in anterior cruciate ligament (ACL) reconstruction.Materials and methods
Thirty-one patients underwent arthroscopic surgery for ACL reconstruction using doubled gracilis and semitendinosus tendons fixed to the tibial tunnel with PLLA-HA (BioRCI-HA) screws. Two groups of patients were evaluated, one group 10–13 months after surgery and the other after 30–40 months. The standard knee ligament evaluation form of the International Knee Documentation Committee (IKDC) was used for clinical assessment and MRI for the radiological assessment.Results
MRI after 10–13 months revealed findings referable to healing and integration of the bone-graft-screw system, findings that disappeared at later follow-up examinations. The BioRCI-HA screw remained constantly visible in all patients, although with changes in signal intensity over time.Conclusions
BioRCI-HA screws allow adequate primary stability and superior osteoconduction and biocompatibility in comparison with plain PLLA screws. The absence of ferromagnetic artefacts allows accurate MRI follow-up and adequate evaluation of ligament synovialisation, screw degradation and graft osteointegration. 相似文献12.
Gunnar Jensen Jan Christoph Katthagen Laura Esther Alvarado Helmut Lill Christine Voigt 《Knee surgery, sports traumatology, arthroscopy》2014,22(2):422-430
Purpose
The purpose of this study was to compare the results after arthroscopically assisted double TightRope®—(TR) reduction with results after clavicular hook plate (HP) fixation in acute high-grade acromioclavicular (AC) joint separations.Methods
Between 2004 and 2010, 69 consecutive patients with acute AC joint separations type Rockwood III and V were subjected to surgical reconstruction. 56 patients (81 %) were available for evaluation. Thereof, 30 (median age: 39 years; n = 12 acute Rockwood III and n = 18 Rockwood V injuries) were treated by a clavicular HP and 26 (median age: 39 years; n = 10 acute Rockwood III and n = 16 Rockwood V injuries) using the double TR technique. Group HP was evaluated at a median of 48 (7–77) months after surgery and the TR group 17 (7–29) months after stabilization. Visual Analogue Scale (VAS) for Pain, Simple Shoulder Test (SST), Constant Score (CS) and Taft Score (TS) were assessed. Sonographic measurements were performed to evaluate recurrent instability.Results
Clinical examination demonstrated comparable results without significant differences. In the groups HP and TR, the VAS was median 0.8 (range, 0.0–7.5) and 0.4 (range, 0.0–5.7), the SST reached median 11 (range, 0–12 points) and 12 points (range, 8–12 points). The CS was median 92.4 % (range, 21.5–105.4 %) and 94.0 % (range, 54.6–105.3 %) and the TS median 10 (range, 3–12 points) and 10 points (range, 5–12 points). Sonographic measurements showed a mean coracoclavicular (CC) distance of 25.3 ± 4.5 (HP) and 25.5 ± 4.3 mm (TR) (n.s.). In both groups, CC distance of the operated side was significantly higher compared to the uninjured side. The complication rate was 13 % in group HP and 12 % in group TR.Conclusions
In acute high-grade AC joint instabilities, both techniques lead to mostly good and excellent clinical results, although comparable partial recurrent vertical instability could be observed. Diagnosis and therapy of concomitant glenohumeral injuries and no obligatory implant removal are advantages of the arthroscopic procedure.Level of evidence
Therapeutic; retrospective comparative study, Level III. 相似文献13.
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PET-CT: a matter of opinion? 总被引:7,自引:3,他引:4
Jager PL Slart RH Corstens F Oyen WJ Hoekstra O Teule J 《European journal of nuclear medicine and molecular imaging》2003,30(3):470-1; author reply 471
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Farrokh D 《Journal de radiologie》1999,80(11):1572-1574
A case of subperiosteal osteoid osteoma of the tibia misdiagnosed as stress fracture based on a history of multiple trauma and the results at MRI and bone scintigraphy is described. The nidus was well demonstrated at CT and the diagnosis was confirmed at histology. The role of different imaging techniques and their pitfalls are discussed. 相似文献
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Etienne Blain-Paré Matthieu Ehlinger Jean-Claude Dosch Thomas Moser 《Skeletal radiology》2013,42(8):1089-1095