A New Methodology to Determine the Anatomical Center and Radius of Curved Joint Surfaces

2006 ◽  
Vol 1 (2) ◽  
pp. 173-175
Author(s):  
Dominik C. Meyer ◽  
Norman Espinosa ◽  
Urs Lang ◽  
Peter P. Koch
Keyword(s):  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Joint Surface ◽  
Joint Surfaces ◽  
The Mean ◽  
The Cross ◽  
Mechanical Tool ◽  
Isometric Point ◽  
Crossing Point

This study describes a mechanical tool which allows us to determine the radius and center of curved joint surfaces both intraoperatively and in vitro. The tool is composed of longitudinal parallel hinges, connected with cross bars on one end. In the middle of each cross bar, one needle is attached at an angle of 90deg to both the hinges and the cross bars. When the parallel hinges are held against a curved surface, they will adapt to the curvature and the needles on the cross bars will cross each other. The crossing point of two needles represents the mean center of the curvature within the plane spanned by the needles. The radius is the distance between the center of curvature and the joint surface. The proposed tool and method allow us to determine the mean center of convex or concave curvatures, which often represent the isometric point of a corresponding curved joint surface. Knowing the radius and center of curvature may facilitate various surgical procedures such as collateral or cruciate ligament reconstruction. Appropriate adaptations of the tool appear to be a useful basis for biomechanical and anatomical joint analyses in the laboratory.

scholarly journals Autologous conditioned plasma in anterior cruciate ligament reconstruction with hamstrings – short term clinical results

2012 ◽  
Vol 18 (3) ◽  
pp. 111-115
Author(s):  
O.M. Russu ◽  
I. Gergely ◽  
Ancuța Zazgyva ◽  
I. Moldovan ◽  
T.S. Pop
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Clinical Results ◽  
Interference Screw ◽  
Lysholm Score ◽  
Cruciate Ligament Reconstruction ◽  
The Mean ◽  
Anterior Cruciate

Abstract Evaluating the early clinical results of anterior cruciate ligament reconstruction using hamstrings autograft, with interference screw on the tibial side (biocomposite interference screw, ConMed-Linvatec) and continuous closed loop fixation on the femoral side (XO-Button, ConMed-Linvatec), with and without intra-articular injection of autologous conditioned plasma (ACP). Our study included 21 patients with chronic anterior cruciate ligament (ACL) ruptures for whom we performed ACL reconstruction with a hamstrings autograft. The mean age was 34 years (range, 25 to 42), 16 patients were men and 5 were women. In 10 cases we performed an intraarticular infiltration of ACP at the end of the surgical intervention. Final evaluation was performed at the end of the 6th postoperative month using the Lysholm scoring system, Tegner activity scale and objective assessment with the RolimeterTM 50A. The Lysholm score was excellent in all cases at 6 months postoperatively, with a mean Lysholm score of 90 for patients without ACP and 91.09 for patients that received ACP; the mean Tegner activity score was also similar pre- and postoperatively for the two groups (from 3.5 and 3.63 for the group without ACP and the group with ACP to 5.6 and 5.72 respectively). Joint laxity measurement was similar for both groups. We found no graft ruptures. We found similar results after ACL reconstruction with and without intra-articular injection of PRP, but further studies are necessary to determine the exact role of these substances in speeding up the recovery process in these cases.

scholarly journals Evaluating the Subtalar Joint in Tibiotalocalcaneal Nail

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0040
Author(s):  
Megan Reilly ◽  
Kurosh Darvish ◽  
Soroush Assari ◽  
John Cole ◽  
Tyler Wilps ◽  
...  
Keyword(s):  
Surface Area ◽  
Subtalar Joint ◽  
Articular Surface ◽  
Joint Surface ◽  
Central Dome ◽  
Below The Knee ◽  
Joint Surfaces ◽  
Circular Surface ◽  
The Mean ◽  
Pass Through

Category: Hindfoot Introduction/Purpose: In tibiotalocalcaneal nails for arthrodesis, the path of the nail through the subtalar joint has not been well documented. Ideally, the defect caused by reaming and the nail does not pass through the joint surface so that the amount of bony contact between the talus and calcaneus is maintained in order to optimize fusion. Our hypothesis is that the TTC nail does not destroy a significant amount contact area between the talus and calcaneus. However, using larger diameter nails (which are inherently stronger) will have more of an effect on the contact surface. Methods: Five cadaveric below the knee specimens were obtained. The ankle was disarticulated on each specimen. Subsequently, a guidepin was drilled from the central dome of the talus down to the calcaneus. The 11 mm reamer was then passed over the guidepin through the calcaneus to simulate retrograde reaming of a TTC nail. Then, the subtalar joint was dissected open and the articular surface was documented in comparison with the area that was reamed out. Measurements were then made, using software that calculated two dimensional surface area to determine the percentage of actual subtalar joint area that was reamed out. The mean percentage of articular area that was removed with the reamer was then calculated. Results: Among the five specimens, in the calcaneus, the mean total articular area was 599mm2±113 and the mean drilled articular area was 21mm2±16. The percentage of the calcaneal articular surface that was removed with the reamer was 3.4%±1.9. In the talus, the mean total articular area was 782mm2±130 and the mean drilled articular area was 39mm2±18. The percentage of the talar articular surface that was removed with the reamer was 5.0%±2.3. Additionally, an 11 mm reamer makes a circular surface area of 95mm2, and the statistics above indicate that a significant portion of the reamed area is nonarticular, within the calcaneal sulcus or the talar sulcus. Conclusion: In a tibiotalocalcaneal nail the subtalar joint is typically incompletely visualized, however this anatomic study demonstrates that the 11 mm reamer eliminates about 3.4% of the calcaneal articular surface and about 5% of the talar articular surface. Therefore, the majority of the articular surface is left intact, which is ideal in optimizing arthrodesis outcomes. Furthermore, this study could extrapolate the effects of a larger nail on the availability of joint surface. It could also be used to argue for cartilage stripping of the affected joint surfaces in arthrodesis preparation, because the majority of the articular surface is, in fact, left intact.

Outcomes of 1- Versus 2-Stage Revision Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis

2020 ◽  
pp. 036354652092309
Author(s):  
Matthew Colatruglio ◽  
David C. Flanigan ◽  
Joseph Long ◽  
Alex C. DiBartola ◽  
Robert A. Magnussen
Keyword(s):  
Systematic Review ◽  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Patient Reported ◽  
The Mean ◽  
Anterior Cruciate

Background: Anterior cruciate ligament reconstruction (ACLR) is a common orthopaedic sports medicine procedure, but graft failure is not uncommon and often leads to revision ACLR. Revision surgery can be performed in a 1- or 2-stage fashion. Hypothesis: Graft failure risk, patient-reported outcomes, and anterior knee laxity are similar after 1- and 2-stage revision ACLR. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed to evaluate patient outcomes after 1- versus 2-stage revision ACLR. A search was performed with the phrase “revision anterior cruciate ligament reconstruction” across Embase, PubMed, Scopus, and SportDiscus from the beginning of their archives through July 12, 2019. Results: Thirteen studies met inclusion criteria and included 524 patients: 319 patients who underwent 1-stage revision ACLR and 205 patients who underwent 2-stage revision ACLR. Two studies compared outcomes of 1- versus 2-stage revision ACLR; 4 studies reported outcomes after 2-stage revision ACLR; and the remaining 7 studies documented outcomes after 1-stage ACLR. The mean follow-up was 4.1 years. The 2 studies that compared 1- versus 2-stage ACLR reported no differences in functional, radiologic, or patient-reported outcomes or failure risk. Overall, 9 studies reported subjective International Knee Documentation Committee (IKDC) scores; 4 studies, Knee injury and Osteoarthritis Outcome Score values; 8 studies, Lysholm scores; and 7 studies, Tegner scores; 8 studies measured anterior laxity with a KT-1000 arthrometer. The mean weighted subjective IKDC score for all studies including this outcome at final follow-up was 66.6 for 1-stage revisions and 65.9 for 2-stage revisions. Conclusion: The available evidence comparing 1- versus 2-stage revision ACLR is retrospective and limited. The results of each approach are similar in appropriately selected patients.

scholarly journals An in vitro biomechanical comparison of anterior cruciate ligament reconstruction: single bundle versus anatomical double bundle techniques

Clinics ◽  
2008 ◽  
Vol 63 (1) ◽  
Author(s):  
Sandra Umeda Sasaki ◽  
Roberto Freire da Mota e Albuquerque ◽  
César Augusto Martins Pereira ◽  
Guilherme Simões Gouveia ◽  
Júlio César Rodrigues Vilela ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Single Bundle ◽  
Bundle Versus ◽  
Cruciate Ligament Reconstruction ◽  
Anterior Cruciate ◽  
Biomechanical Comparison

scholarly journals Comparison of clinical outcomes after anterior cruciate ligament reconstruction with autogenous hamstring tendons and peroneus longus allograft

2017 ◽  
Vol 5 (2_suppl2) ◽  
pp. 2325967117S0004
Author(s):  
Rodi Ertoğrul ◽  
Hasan Basri Sezer ◽  
Raffi Armağan ◽  
Muharrem Kanar ◽  
Osman Tugrul Eren
Keyword(s):  
Anterior Cruciate Ligament ◽  
Anterior Cruciate Ligament Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Cruciate Ligament Reconstruction ◽  
Peroneus Longus ◽  
The Mean ◽  
Anterior Cruciate ◽  
Autograft Group

In this study we reported the early clinical and functional results of 40 patients admitted to our hospital for anterior cruciate ligament reconstruction (20 with autogenous hamstring tendon graft and 20 with peroneus longus allograft)retrospectively between august 2012 and september 2014. All patients in the autograft group were male and only three patients in the allograft group were female. The mean age in the autograft group was 29,60±4,55 and 34,25±6,73 in the allograft group. The mean time period before the surgery was 10,35(1-84) months and the mean postoperative follow up time was 33,8(12-46) months. Only 2 patients in the autograft group and 4 patients in the allograft group were injured by direct trauma. We noted the patients’ occupation, activity level and sport activities. Joint effusion, pain and restriction in the joint motion were documented. Patients were evaluated with Lachman, anterior drawer and pivot shift tests at the last follow up examination. The joint instability was tested with KT 1000 and the muscle contractions were tested with Cybex devices. Modified Cincinnati, Lysholm and IKDC activity scale were used to evaluate the activity level of patients. There were no difference neither clinically, nor functionally between two groups at the last follow up (p>0,05).Taken into consideration the risks and advantages of autogenous hamstring graft and allograft use we conclude that the peroneus longus allograft is a reasonable option for anterior cruciate ligament reconstruction.

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