Arthroscopic hamstring anteriorcruciate ligament reconstruction with endobutton femoral fixation

Numerous techniques of anterior cruciate ligament (ACL) reconstruction have been described in literature. All haveinherent advantages and disadvantages. Autogenous hamstring grafts provide adequate strength while avoiding donor site morbidity associated with bone-patellar tendon-bone harvest. Endobutton femoral fixation allows precise femoral tunnel placement without a second incision. This article describes our technique of endoscopie ACL reconstruction using a doubled semitendinosus autograft with Endobutton femoral fixation.     

Anterior cruciate ligament reconstruction with hamstring tendons

Reconstruction of the anterior cruciate ligament using hamstring tendons can be successfully accomplished.Semitendinosus and gracilis tendon autografts offer advantages over other commonly used autografts in that they are strong, have stiffness characteristics similar to a normal anterior cruciate ligament, have a large surface area for revascularization, and are adaptable to precise intraarticular positioning. The use of hamstring tendon autografts for anterior cruciate ligament reconstruction avoids the potential surgical morbidity associated with the harvest of autogenous patellar tendon grafts. As with all anterior cruciate ligament reconstructive procedures, attention to detail is essential for a predictable successful outcome, Attention must be paid to graft preparation, tunnel placement, graft fixation and tensioning, and postoperative rehabilitation. When proper attention to detail is performed, restoration of normal anterior laxity with a full range of knee motion can be expected. This technique is particularly applicable in those cases where avoidance of the extensor mechanism is desirable.     

无滑膜肌腱滑膜化的实验研究及其意义

将家兔和胎儿的鞘外无滑膜肌腱段分别放入膝关节腔内进行在体肌腱培养和体外与滑膜细胞联合培养。结果显示：在体培养的肌腱段表面出现了光滑的，具有滑膜组织形态结构的特征，游离于关节腔内，无粘连发生；体外与滑膜细胞联合培养的胎儿肌腱段表面，被滑膜细胞爬行并覆盖。实验表明：无滑膜肌腱在滑液环境中可向有滑膜肌腱转化，并且可以通过体外培养进行滑膜化改造，使之滑膜化。     

手法治疗髌骨软化症320例疗效观察

目的观察手法治疗髌骨软化症的效果.方法采用揉捻、( )、散等手法治疗髌骨软化症320例.结果临床治愈295例,好转24例,总有效率99.7%.结论手法是治疗髌骨软化症的有效方法.     

刘长信自拟经验方泡腿疗法治疗膝关节骨性关节炎

刘长信教授认为,膝关节骨性关节炎的病因病机是由于筋骨失营,风寒湿等邪气乘虚而侵袭膝部,体内正气被邪气瘀阻难以通调全身,以致膝部气血凝滞。在临床治疗上以筋骨并重,以筋代骨,强调“经筋”的重要性,同时注重祛风除湿,散寒止痛。腿浴疗法可利用水温本身对皮肤、经络、穴位的刺激和药物的经皮吸收,达到治疗疾病、养生保健的目的。     

Rupture haute des tendons ischiojambiers chez le sportif. À propos d'une série de neuf cas opérés

Objectives

Muscular pathology of the hamstring is frequent among athletes. On the other hand, complete rupture with avulsion at the proximal bone-tendon junction is a rare injury. Functional treatment of this injury gives no successful results. This study aims at providing information on the results of operations on 9 athletes.

Methods

Between 2002 and 2006, 9 male patients with an average age of 36.4 years (from 20 to 59) were operated on for a complete rupture of the hamstring at the proximal bone tendon junction due to sporting accidents — 4 rugby accidents, two soccer, one fencing and one aikido accident — and one domestic accident. Emergency magnetic resonance imaging was systematically employed. All nine were operated on using the same technique: by reinserting the tendons into the bone with several Mitek GII^® anchors (3.6 on average). A specific rehabilitation programme was set up. An isokinetic Biodex™test was done after 6 months.

Results

All 9 patients were reviewed after a mean period of 33 months (from 9 to 64). At the last review, all patients were satisfied with their functional results. Eight patients out of 9 had gone back to their sporting activities at the same level, a mean 5 months after the operation (from 4 to 7 months). The isokinetic tests related to the unimpaired member show a muscular deficit of less than 8% after the 6th month.

Conclusion

Complete rupture of the hamstring at the proximal bone tendon junction is a rare but serious injury. With an early diagnosis and rapid surgical treatment, normal functions can be recuperated with a rapid return to high level sporting activity.     

Greater Trochanteric Pain Syndrome Negatively Affects Work,Physical Activity and Quality of Life: A Case Control Study

Musculoskeletal injury causes pain and when chronic can affect mental health, employment and quality of life. This study examined work participation, function and quality of life in people with greater trochanteric pain syndrome (GTPS, n = 42), severe hip osteoarthritis (OA, n = 20) and an asymptomatic group (ASC, n = 23). No differences were found between the symptomatic groups on key measures, both were more affected than the ASC group, they had lower quality of life score (p < 0.001), Harris Hip Score (p < 0.001) and higher Oswestry Disability Index (p < 0.001). Participants with GTPS were the least likely to be in fulltime work (prob. GTPS = 0.29; OA = 0.52; and ASC = 0.68). GTPS appears to confer levels of disability and quality of life similar to levels associated with end stage hip OA.     

自体腘绳肌腱重建内侧髌股韧带治疗复发性髌骨脱位：中期随访评价

背景：以自体腘绳肌腱重建内侧髌股韧带是现在较流行的修复方式。目的：观察重建内侧髌股韧带治疗复发性髌骨脱位的中期临床疗效。
　　方法：回顾性研究2006年9月至2009年9月因复发性髌骨脱位而接受内侧髌股韧带重建的患者24例(25膝)资料,随访时间2-5年,平均3.1年,观察临床疗效、膝关节功能恢复及CT评估髌骨位置。
　　结果与结论：随访结果显示,IKDC 评分优良率为92%,2例(8%)患者再次发生髌骨脱位,需要再次手术治疗,随访时IKDC评分、Tenger评分、Lycholm评分明显高于术前(P<0.01)。结果证实,自体腘绳肌腱重建内侧髌股韧带治疗髌骨脱位中期临床疗效较好。