1.Morphometric Analysis of Anatomy of Anterior Cruciate Ligament of Knee and its Attachments - a Cadaveric Study in Indian Population
Mishra S ; Mylarappa A ; Satapathy D ; Samal S
Malaysian Orthopaedic Journal 2021;15(No.3):8-14
Introduction: The Anterior Cruciate Ligament tends to
stabilise the knee in various range of extension and flexion.
Precise study of anatomy, attachments and position of
bundles is important for successful ACL reconstruction. In
our study, we attempt to assess general anatomy of ACL,
determine and compare its morphometric data pertaining to
length and width and its tibio-femoral foot prints in different
gender and secondarily determine changes in the same
during ACL dynamics witnessed during knee flexion
changes.
Materials and methods: A total of 19 knees from 10
cadavers were used in the research with mean age of 61±7
years. After dissecting the skin, muscles, patellar and
articular capsule were removed and bundle attachments were
studied. Thereafter the relative length, width and stiffness of
ACL bundles at 0, 90, 140 (maximum) angles of knee flexion
were measured along with maximum horizontal and vertical
bundle footprints at tibio-femoral attachments were
recorded.
Results: Mean length and width of insertion of anteromedial
(AM) bundle on the tibial surface was 8.8mm and 9.0mm in
males and 8.1mm and 8.8mm in females. Furthermore, that
of PL bundle was 9.1mm and 7.8mm in males and 8.9mm
and 7.1mm in females.
Conclusion: The anteromedial (AM) bundle and
posterolateral (PL) bundle of ACL were found to be most
relaxed at full extension and were most taut at maximum
flexion of 140°. AM bundle underwent greater stretching and
change of length in comparison to the PL bundle, indicating
that it is comparatively a more dominant bundle.
2.A Rare Case of Giant Cell Tumour of Bilateral Achilles Tendon Sheath - Reconstruction with Dual Tendon Transfer: A Case Report
Samal P, MS Ortho ; Mohapatra NC, MS Ortho ; Mishra J, MS Ortho ; Mylarappa A, MS Ortho ; Das P, MD Patho
Malaysian Orthopaedic Journal 2020;14(No.1):84-87
Giant cell tumour of tendon sheath is a benign soft tissue lesion most commonly found in the flexor aspect of hand and wrist. However, it is uncommon in foot and ankle and rare in bilateral achilles tendon. We report a case of 17-year-old female who presented with progressive enlargement of bilateral achilles tendon for six months. MRI findings showed that most of the tumour had intermediate to low signal intensity. Histopathology confirmed the diagnosis of giant cell tumour of tendon sheath. To help the patient regain the strength of the achilles tendon and walking abilities, a large area of tendon tumour was excised, followed by reconstruction with transfer of the peroneus brevis (PB) and posterior tibial (PT) tendon autograft. At two years followup, functional result was satisfactory.