OBJECTIVETo introduce the process and outline of fluoroscopy-based navigation system assisted anterior cruciate ligament (ACL) reconstruction, and evaluate its feasibility and accuracy.

METHODSFrom September 2005 to February 2006, there were 30 cases ACL rupture patients who received fluoroscopy-based navigation system assisted arthroscopy operations for ACL reconstruction (navigation group). At the same time, there were 40 patients who underwent traditional ACL operation (traditional group). For the navigation group, the proper placement of femoral and tibial tunnels was planned preoperatively in standard AP and lateral X-ray view. Intraoperative fluoroscopic images were taken and input into navigation computer system to form the virtual interactive working fields. After placement and registration, signals from patient trackers, which fixed on the distal femur and tibia respectively, and tool trackers, which attached with ACL tibial and femoral guide, were captured by the optic navigation camera and the navigation computer system could pursue the real-time position of the ACL tools and projected into working field to help precise placement of femoral and tibial tunnels. Then results of two groups were observed and evaluated.

RESULTSFor navigation group, the mean time extension was 20 min. The tibial tunnel position was measured in all these cases. The tibial tunnel position of navigation group was 45.90% (SD 2.36%), and the traditional group was 41.05% (SD 6.01%). The difference was statistically significant (P < 0.05).

CONCLUSIONFluoroscopy-based navigation system assisted ACL reconstruction improves the accuracy and reproducibility of the tunnel placement.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Arthroscopy ; methods ; Bone-Patellar Tendon-Bone Grafting ; methods ; Female ; Femur ; surgery ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Surgery, Computer-Assisted ; methods ; Tibia ; surgery ; Treatment Outcome

OBJECTIVETo evaluate the clinical result of arthroscopic anterior cruciate ligament (ACL) reconstruction with either allo- or auto- bone-patellar tendon-bone (B-PT-B) grafts.

METHODSFrom February 2002 to January 2006, 142 of 187 cases of ACL ruptures who received ACL reconstruction with B-PT-B grafts were studied retrospectively. There were 93 male and 49 female whose age was from 15 to 57 years (mean 26 years). Patients were divided into 2 groups by graft selection: 38 patients with autograft and 104 with allograft. Clinical results were evaluated according to IKDC, Lysholm, Irgang and Larson scales. Sub-items of scales such as pain, swelling and laxity were specifically evaluated.

RESULTSAll of the patients were followed up with an average of 24 months (range from 6 to 43 months). All grafts were radiographically in good position at the time of follow-up. KT-1000 examination of affected knee showed less than 3 mm anterior translation difference compared with contralateral one's. Allograft group: 85 patients got normal IKDC score (81.7%). Lysholm score 82.8 +/- 8.5, Irgang score 79.2 +/- 7.3, Larson score 86.7 +/- 3.1. Autograft group: 29 patients got normal IKDC score (76.3%). Lysholm score 84.6 +/- 9.5, Irgang score 79.5 +/- 7.6, Larson score 88.9 +/- 6.8. No significant statistical difference was found between the 2 groups in the comprehend scale (P>0.05).

CONCLUSIONSBoth autograft and allograft group achieve good results, and the allograft B-PT-B could provide the similar clinical result as autograft, the preliminary result of allograft reconstruction might indicate predictable result in the future.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; Bone-Patellar Tendon-Bone Grafting ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Matched-Pair Analysis ; Middle Aged ; Reconstructive Surgical Procedures ; methods ; Retrospective Studies ; Transplantation, Autologous ; Transplantation, Homologous ; Treatment Outcome

OBJECTIVETo summary the experience in the diagnosis and management of septic arthritis after anterior cruciate ligament (ACL) reconstruction.

METHODSThe knee joint infections after arthroscopic anterior cruciate ligament reconstruction were retrospectively studied. From January 1997 to July 2007, 16 of 3638 patients undergoing anterior cruciate ligament reconstructions experienced postoperative septic arthritis. The incidence, cause, presentation, laboratory results, treatment, and outcome of all infected patients were analyzed. The experiences of diagnosis and management of septic arthritis after anterior cruciate ligament reconstruction were summarized.

RESULTSThe incidence of septic arthritis after ACL reconstruction was 0.44%. The most common symptoms of the infected patients were fever, swelling, severe pain, tenderness, restricted motion. Eleven (68.8%) patients were positive for bacteria cultures, and Staphylococcus epidermidis was the most common bacteria. Nine of the 16 patients were performed arthroscopic debridement, and the other 7 patients were conservatively treated. All patients regained full range of motion and normal stability at the 19.7 months follow-up.

CONCLUSIONSSeptic arthritis, which could bring the dysfunction of the joint, is subsequent with cartilage injury and the failure of the ACL grafts. Early diagnosis and treatment of arthroscopic debridement in time are essential to the ultimate clinical outcome.

Adolescent ; Adult ; Aged ; Anterior Cruciate Ligament ; surgery ; Arthritis, Infectious ; diagnosis ; etiology ; therapy ; Arthroscopy ; Bone-Patellar Tendon-Bone Grafting ; Child ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Male ; Middle Aged ; Postoperative Complications ; diagnosis ; etiology ; therapy ; Prognosis ; Retrospective Studies

OBJECTIVESTo evaluate the 4- to 10-year results of arthroscopic reconstruction of the posterior cruciate ligament (PCL) using single-bundle bone-patella tendon-bone graft, and to find out the principle and influential factor of the isolated PCL reconstruction.

METHODSFrom May 1998 to July 2004 the data of 29 patients with isolated PCL reconstruction retrospectively investigated, using single-bundle bone-patella tendon-bone graft. Twenty-two cases were followed up with average 7.1 years (5 - 10 years). Follow-up included the subjective knee function evaluation, KT2000, Biodex and the radiographic assessment.

RESULTSThe mean final follow-up IKDC score, Lysholm score, and Tegner score of the 22 cases were 89.4 +/- 8.1, 94.5 +/- 9.2, and 6.9 +/- 2.6 respectively. There were statistically significant improvements in them when compared with preoperative data respectively (P < 0.01). The average posterior displacement measured with KT2000 was (4.9 +/- 1.1) mm (90 degrees flexion) and (4.3 +/- 1.2) mm (30 degrees flexion) respectively. At the final follow-up, KT2000 examination revealed >or= 6 mm of posterior laxity in 6 patients (group A), and

CONCLUSIONSArthroscopic reconstruction of the posterior cruciate ligament using single-bundle bone-patella tendon-bone graft produces well results with moderate to long term follow-up. For the patients with III or IV PCL injury, PCL reconstruction should be done as soon as possible.

Adolescent ; Adult ; Arthroscopy ; Bone-Patellar Tendon-Bone Grafting ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Posterior Cruciate Ligament ; surgery ; Reconstructive Surgical Procedures ; methods ; Transplantation, Autologous ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the feasibility of hamstring autograft anterior cruciate ligament reconstruction with hamstring tendons insertion on tibia preserved and an implant fixation technique of hamstring tendons knot and bone bolt press-fit.

METHODSTwenty cases of injured anterior cruciate ligament were reconstructed. There were 15 males and 5 females with the average age of 22 years old. Ten left knees and 10 right knees were involved. Hamstring tendons were taken, and pretension was performed. Tibial tunnel and femoral tunnel were prepared,and the femoral tunnel was a frame of narrow inside and wide outside. The hamstring tendons knot and bone bolt were pulled inside of femoral tunnel. The tendons distal of tendons knot were brought to pass the femoral tunnel, joint capsule and another tibial tunnel. Then, the tendons distal of tendons knot were tightened together with the part of hamstring tendons of which the insertion were on tibia. After the operation, the knee was fixed at a flexion of 45 degrees by brace.

RESULTSThe patients were followed up for 8 to 24 months. The function of troubled knees was evaluated by Lysholm knee functional scale. The average knee score were 61.5 +/- 4.6 and 92.5 +/- 3.7 respectively before and after operation, and the difference was statistically significant (P < 0.05).

CONCLUSIONHamstring tendons insertion on tibia preserved and an implant fixation technique of hamstring tendons knot and bone bolt press-fit was biological fixation for anterior cruciate ligament reconstruction with hamstring. The advantage of this method was avoidance of using high cost material for fixation,which lessened spending for the patients. And it was also benefit for tendon-bone healing.

Adolescent ; Adult ; Anterior Cruciate Ligament ; surgery ; transplantation ; Anterior Cruciate Ligament Injuries ; Bone-Patellar Tendon-Bone Grafting ; Female ; Humans ; Knee Joint ; physiopathology ; surgery ; Male ; Reconstructive Surgical Procedures ; Tendons ; surgery ; transplantation

A 38-year-old man presented with right knee pain and swelling following a football injury. Magnetic resonance (MR) imaging showed a complete anterior cruciate ligament (ACL) tear and lateral meniscal tears. The torn ACL was repaired with a graft obtained from the semitendinosus muscle, and the menisci were debrided. The mechanisms of injury to the ACL are varied and may be due to direct or indirect contact with the knee as well as with twisting injuries. Knowledge of the ACL's normal anatomy, together with MR imaging technique and understanding of the appearance of the lesion on MR examination, is crucial to aid in the identification of an ACL tear. Diagnosis of an ACL tear should be based on direct MR imaging signs, although indirect signs may be helpful, particularly in chronic tears. Other associated injuries to be aware of include meniscal and other ligamentous injuries. Normal ACL graft and post-ACL graft reconstruction complications are also briefly discussed.
Adult ; Anterior Cruciate Ligament ; pathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; adverse effects ; rehabilitation ; Bone-Patellar Tendon-Bone Grafting ; adverse effects ; rehabilitation ; Football ; injuries ; Humans ; Knee Injuries ; pathology ; rehabilitation ; surgery ; Magnetic Resonance Imaging ; Male ; Postoperative Complications ; diagnosis ; Soccer ; injuries ; Tendons ; transplantation