Objective To provide data on the incidence,shape,and sizes of the femoral attach.ments of meniseofemoral ligaments (MFLs),and to determine the function of MFIJs and the role in the femoral tunnel D0sitioning in the double-bundle reconstruction of PCL.Methods Anatomical study:Thirty cadaveric knees were used to investigate the incidence and tightening-slackening patterns during the knee nexion-extension of MFLs.Data were obtained to describe the size,shape,and the relationship between the position of the femoral attachment of MFLs and that of anterolateral bundle(ALB)and the posteromedial bundle(PMB) were detetrained.Clinical study:During arthroscopic reconstruction of PCL,the presence of MFIJs Was confirmed in 1 12 patients by observation and probing,the relationship between the femoral attachment of MFLs and that of ALB and PMB were determined.Results Anatomical study:The Humphry ligament and Wrisberg ligament were presented in l(3%)and 27(90%)case respectively.The femoral attachments were approximately ellipse both.The mean area was(18.14±3.05)mm2 and(25.63±7.92)mm2 respectively.Clinical study:The Humphry ligament and Wrisberg ligament were present in 2 cases(1.7%)and 67 cases(59.8%) respectively.The incidence of MFLs in knees with isolated PCL injury was highter than that in knees with multiple ligaments injuries.Conclusion The incident of MFLs is related to the trauma of the knee.and the Wrisberg ligament plays an important role in avoiding impingement between the ALB and the intereondylar roof during deep knee flexion.The Humphry ligament and the Wrisberg ligament are landmarks for the tunnel positioning of ALB and PMB in double-bundle PCL reconstruction respectively.

Objective To investigate the histological changes and collagen phenotype of a semitendinosus autograft after reconstruction of posterior cruciate ligament(PCL) in rabbits. Methods Twenty skeletally mature New Zealand white rabbits were divided into two groups. In group 1, the PCL of the right knees of 18 mature New Zealand white rabbits were resected and immediaterly reconstructed with double-band semitendinosus antograft. Then the rabbits were respectively killed at 3, 6, 12, 26 and 52 weeks after the operation, to obtain the the semitendinosus autografts. Group 2 consisting of the other 2 rabbits was served as control group, and semitendinosus tendons and PCL were obtained. All specimens were staining with hematoxylin and eosin, toluidine blue and immunohistochemical methods of type Ⅰ, Ⅲ collagens to analyze the histological changes and collagen phenotype of a semitendinosus autograft, and compare those with normal semitendinosus tendons and PCL. Results Histological results demonstrated that there was obvious difference at the cell formation between normal semitendinosus tendon and PCL. After postoperative 52 weeks the graft was similar to the normal PCL, while the alignment of graft was still different from that of normal PCL through necrosis, cell growing in, collagen formation and remolding. Immunohistochemistry result demonstrated: the staining of type Ⅰ collagen in graft was low at first, then increased gradually; the staining of type Ⅲ collagen was low at first, increased quickly, then decreased, at 52 weeks it was present in local areas. But positive reactions for type Ⅰ collagen were localized in collagen fibers, and those for type Ⅲ collagen were localized in synovium in normal PCL. Conclusion The study showed the semitendinosus autograft was still different in cell formation from normal PCL at 52 weeks after PCL reconstruction with semitendinosus.

Objective To study the influence of the rupture of anterior cruciate ligament(ACL) on the menisci. Methods Four hundred and nineteen consecutive patients with rupture of ACL during December 1984 to December 1999 were included in this study. The incidence of meniscal injuries and the correlation of injuries of menisci and cartilage were investigated. Results The incidence of meniscal injuries was increased from 55.6% in acute to 74.1% in sub chronic and 89.8% in chronic. There were significant differences between each two stages (P

Objective To observe the articular cartilage injuries complicated with the rupture of anterior cruciate ligament(ACL)in 21 athletes and 43 non-athletes,and investigate the cause and the pattern of cartilage of knee following the ACL rupture in those patients.Methods The pathologic change,location,degree of cartilage lesion were observed. The relationship between the incidence, occurrent time,degree of cartilage injury and ACL rupture,injured degree of cartilage and the course of ACL rupture were studied.Results The incidence of cartilage injury were 75% in all patients, 66.7% in athletes and 79%in non-athletes. Incidence of cartilage injury in non-athletes was significantly higher than that in athletes (P<0.01).Incidence of serious injury of cartilage in the course more than 1 year was significantly higher than that less than 1 year (P<0.01),but there were no statistical difference between the two groups.Conclusion The incidence of articular cartilage injury following ACL rupture were significantly raised in athletes and non-athletes. The longer the ACL ruptured, the more serious the cartilage injured. Results indicated that articular cartilage injuries in the ACL rupture knee were mainly caused by the instability of knee.

Objective To research for a new method of arthroscopic total meniscectomy with simple instru- ments. Methods One hundred and sixty nine cases were followed up for short period that had been operated on with a forward knife, a back cutting knife, a punch and a 30?scope from Nov. 1992. to Aug. 1998. Results The av- erage time of operation was 78 minutes. The operations had no injury to cartilage and ligament. It is necessary for only 7 .9 percent of patients to take analgesic intramuscularly after operation. Eight patients had a transient tourniquet paral- ysis. All of them could begin to work and exercise after postoperative 2 weeks. Conclusion As compared with the method introduced by David Sisk ,this method has the advantages of simple instruments, fewer ports and complications and minimal trauma Either lateral meniscus or medial meniscus can be cut off by the same method. This method is a safety and a better way to arthroscopic meniscectomy.

In oder to make the bone tunnel in optimal position, effective and firm fixation, early functional recov- ery and minimally operative injury we reported a new technique in reconstructive anterior cruciate ligament(ACL)using patellar tendon autograft fixed with interference screw. With the assistance of arthroscopy 74 patients with ACL rupture were treated between October 1997 and April 1999. The clinical results showed that the operative injury was minimal, fixed bone grafts were accurate and the reconstructed ACL was isometricity. The reconstructed ligament could be fixed biologically and firmly because of used patellor tendon autograft with bone grafts at two end. Clinical experience of ar- throscopic - assisted ACL reconstruction was summarized.

Objective To study the injury mechanism, diagnosis and therapy of traumatic dislocation of the peroneal tendons. Methods 18 cases with traumatic dislocation of the peroneal tendons were operated in our institute from 1986 to 2000. The mechanism of injury and clinical findings were investigated. 2 cases with acute dislocation were operated by suturing the peroneal retinaculum directly. 16 cases with recurrent dislocation were treated with Watson-Jones operation. Results 10 cases with recurrent dislocation were follow-up from 1 year to 15 years with an average of 6.2 years. Only one recurrence due to ankle sprain was found and the other 9 cases had no more dislocation and returned to sports without symptom.Conclusion Traumatic dislocation of the peroneal tendons can be caused by the injury of ankle joint in three positions:dorsiflexsion and eversion, dorsiflexsion and inversion, plantflexsion and inversion. Anti-resistant test of dorsiflexsion and eversion may help diagnosis. Watson-Jones operation has the advantages of simple to apply, minor trauma and sound clinical outcome.

Objective To study the magnetic resonance imaging (MRI) characteristic of bone bruises associated with acute anterior cruciate ligament (ACL) ruptures and to investigate the correlation between bone bruises and cartilage lesions. Methods The MRI findings of 37 cases of acute ACL ruptures associated with bone bruises were studied retrospestively. The classification and distribution of bone bruises were analyzed and the cartilage lesions were also observed under arthroscopy. Results A total of 57 independent bone bruises(type Ⅰ:14, type Ⅱ:32, type Ⅲ:3, type Ⅳ:6 and type Ⅴ:2) were documented by MRI in the 37 patients. 54 (94.7%) bone bruises located in lateral joint compartment with involvement of lateral femoral condyle in 31 and lateral tibial plateau in 23. Nine cases (15.8%) of articular cartilage lesions were found under arthroscopy in the area overlying bone bruises. Conclusion Bone bruises associated with acute ACL ruptures mainly located in the lateral compartment of knee, especially in anterior portion of lateral femoral condyle and posterior portion of lateral tibial plateau. Arthroscopic cartilage lesions were not corresponding to bone bruises.

Objective To evaluate the mid-term(44 months) outcomes of meniscus allograft transplantation in four patients.Methods Between June and July 2005,four patients(3 medial and 1 lateral;3 men and 1 women;aged 21,27,35,38 years) underwent arthroscopy-assisted meniscus allograft transplantation in our hospital.The clinical outcome of the patients was evaluated by assessing the symptoms and signs,IKDC,Lysholm,and Tegner scores and examining the anteroposterior and lateral radiographs of the transplanted knee,weight-bearing radiographs of the both knees,anteroposterior radiographs of the lower extremities as well as magnetic resonance imaging(MRI).One patient underwent second-look arthroscopy. Results The follow-up time was 44-45 months.During the period,all the patients showed a normal motion range of the knee without pain or effusion of the knee joints.The mean IKDC,Lysholm,and Tegner scores of the patients were 84.75?2.63,91.50?4.43 and 7.00?0.82 respectively,which were significantly higher than those detected before the operation(60.50?14.06,69.25?22.04 and 4.00?0.82).The radiological results revealed no obvious degeneration or alignment changes though a 2-mm narrowing was shown in one of the patients.MRI showed mild extrusion for the body of the transplanted medial menisci and Ⅱ to Ⅲ stage signal for the body and the posterior horn.Almost normal performance and tension of the transplanted meniscus was shown by arthroscopy. Conclusions Meniscus allograft transplantation shows good outcomes in mid-term follow-up.MRI is valuable for evaluating the implanted meniscus.

Objective To study the effects of continuous passive motion(CPM)on tissue blood oxygen saturation(StO2)in the edge of wound after anterior cruciate ligament(ACL)reconstruction in rabbits.Methods Twenty male New Zealand rabbits,aged 8 months,received an ACL reconstruction by using double semitendinous tendon autograft in the right hind leg.The rabbits were randomly divided into 2 groups postoperatively,namely Cage activity group(n=10)and CPM group(n=10),treated with cage activity and activity by rabbit knee joint continuous passive motion apparatus respectively.On the following day after operation,a near-infrared optical device and ODISseyTM Tissue Oximeter were applied to measure the changes of tissue oxygen saturation(StO2)in the edge of the wound in each cycle(with flexion of 30?-110?)and various CPM speeds(2.35?/s,3.2?/s,and 8?/s),and the optimal CPM range and speed was thus selected for analyzing the changes of StO2 in local tissues of wounds with various angles of CPM in knee joint before the operation and on the 2nd,4th,6th,8th,10th,and 14th postoperative days.Results There was a significant difference with regard to StO2 between CPM group and Cage activity group(P0.05),however,a significant difference was observed among different time points(before the operation,and 2,4,6,8,10,14 days after the operation)(P