Femoral Tunnel Positioning in Anterior Cruciate Ligament Reconstruction: Anteromedial Portal versus Transtibial Technique-A Randomized Clinical Trial.

 The purpose of this study was to investigate, through three-dimensional computed tomography (3D-CT), the accuracy of femoral tunnel positioning in patients undergoing anterior cruciate ligament (ACL) reconstruction, comparing transtibial (TT) and anteromedial (AM) techniques.  We evaluated postoperative 3D-CT scans of 26 patients treated with ACL reconstruction with hamstrings autograft using a low accessory AM portal technique and 26 treated with the TT technique. The position of the femoral tunnel center was measured with the quadrant method.

Use of innovative biomimetic scaffold in the treatment for large osteochondral lesions of the knee.

Purpose: Large osteochondral defects involve two different tissues characterized by different intrinsic healing capacity. Different techniques have been proposed to treat these lesions with results still under discussion. The aim of the study is to evaluate the clinical outcome of 19 patients treated with a type I collagen-hydroxyapatite nanostructural biomimetic osteochondral scaffold at minimum follow-up of 2 years.

The clinical diagnosis of meniscal tear is not easy. Reliability of two clinical meniscal tests and magnetic resonance imaging.

Aim: to clarify the reliability of two clinical meniscal tests, McMurray's and Apley's and the MRI imaging, in order to establish how to reduce unjustified arthroscopies.

Methods: 102 patients were selected out of 160. All patients were submitted to a triple clinical examination (by a young surgeon and two skilled surgeons), MRI and an arthroscopic procedure.

Articular cartilage engineering with Hyalograft C: 3-year clinical results.

Unlabelled: The use of tissue engineering for cartilage repair has emerged as a potential therapeutic option and has led to the development of Hyalograft C, a tissue-engineered graft composed of autologous chondrocytes grown on a scaffold entirely made of HYAFF 11, an esterified derivative of hyaluronic acid. Here we present the results of an ongoing multicenter clinical study conducted with the primary objective to investigate the subjective symptomatic, functional and health-related quality of life outcomes of patients treated with Hyalograft C. Clinical results on the cohort of 141 patients with followup assessments ranging from 2 to 5 years (average followup time: 38 months), are reported.

Surgical management of chronic, unreduced posterior dislocation of the shoulder.

Four patients with chronic posterior dislocation of the shoulder underwent surgical treatment after an average delay of 10 months from injury. They were examined clinically and radiographically at an average follow-up of 32 months. Treatment consisted of subscapularis tendon transfer (McLaughlin procedure) into the humeral defect in one case, transfer of the lesser tuberosity (McLaughlin modified procedure) in two cases, and in the fourth case-a patient with a 19-month missed dislocation and 50% humeral head lesion-a transposition of the coracoid process and conjoined tendon was performed.

Deep venous thrombosis and pulmonary embolism after knee arthroscopy in athletes carrying the thrombophilic factor lupus anticoagulant.

In patients undergoing arthroscopic knee surgery, deep venous thrombosis and pulmonary embolism are rare and there is not clear indication as to the necessity of thromboprophylactic treatment in these patients. However, the role of coagulation disorders in thrombotic events following arthroscopy is unknown. We report 2 cases of massive deep venous thrombosis and pulmonary embolism after knee arthroscopy in athletes carrying the thrombophilic factor lupus anticoagulant, but with no personal or familial history of thrombotic diseases.

Tibial intercondylar eminence fractures in adults: arthroscopic treatment.

Results obtained from the surgical treatment of 15 cases of type II and III tibial intercondylar eminence fractures-according to the classification of Meyers and McKeever [12, 13]-are reported in this paper. The average age of the patients observed was 22 years (range 18-41). All patients underwent an arthroscopic procedure of reduction and fixation.

Onset of Berger disease after Staphylococcus aureus infection: septic arthritis after anterior cruciate ligament reconstruction.

Septic arthritis is rare in patients undergoing knee arthroscopic surgery. If the infection is due to Staphylococcus aureus, patients might experience fever, severe clinical syndromes, and extra-articular manifestations, including vasculitis and glomerulonephritis. We describe a case of onset of immunoglobulin A nephropathy (Berger disease) after S aureus septic arthritis complicating an anterior cruciate ligament surgical reconstruction.

Results of autologous osteochondral grafts in chondral lesions of the knee.

Background: To evaluate multiple osteochondral autografts for the treatment of traumatic chondral lesions of the knee.

Methods: Twenty-four (19 male and 5 female) patients underwent multiple osteochondral transplantation from 1995 to1999, the age ranging from 19 and 47 years old. Osteochondral lesion was localized on the femoral condyle in 21 cases, on the patella in 1 case and on the femoral groove in other 2 cases.

Porosity-graded hydroxyapatite ceramics to replace natural bone.

Porous hydroxyapatite HA bodies were prepared with an aim to simulate bone tissue morphology. By varying the characteristics of starting HA powders and the impregnation strategy of cellulosic sponges with rheologically optimized slurries, a wide range of physico-chemical and mechanical properties of the porous ceramics can be obtained. The samples were characterized microstructurally, by density and porosimetry and by mechanical strength.

Tibial plateau fracture after arthroscopic anterior cruciate ligament reconstruction.

Complications have been described with each technique for reconstruction of the anterior cruciate ligament (ACL) in the knee, both open and arthroscopically assisted. The authors describe a case of tibial plateau fracture occurring 7 months after an ACL reconstruction using the half tunnel technique. The fracture occurred at the tibial fixation site and required open reduction with internal fixation.

Localized pigmented villonodular synovitis of the knee: report of two cases of fat pad involvement.

The localized form of pigmented villonodular synovitis (PVNS) is a rare pathological entity characterized by a limited involvement of the synovium. The knee is most commonly affected. In the knee joint, the disorder generally presents as a nodular, pedunculated lesion protruding into the articular cavity.

Light and scan electron microscopic analysis of cyclops syndrome: etiopathogenic hypothesis and technical solutions.

The loss of range of motion after anterior cruciate ligament (ACL) reconstruction is one of the most common and most challenging complications of this kind of surgery. Recently, an intercondylar notch fibrous proliferation, called cyclops syndrome because of its arthroscopic appearance, has been identified as one of the specific causes of loss of extension. The incidence of cyclops syndrome is 2%-4% [17, 18], but there is still no understanding of its etiology.

Bone-ligament interaction in patellar tendon reconstruction of the ACL.

The bone-ligament junction is one of the most complex biological tissues. Its key function is distribution of mechanical loads applied to the ligament in such a way as to diminish the concentration of stresses or shearing at the interface. This paper reports an experimental assessment of the extent to which a nearly normal junction is formed following reconstruction of the anterior cruciate ligament (ACL) with patellar tendon in 20 New Zealand white rabbits sacrificed after 2-38 weeks.

Role of arthroscopic lateral release in the treatment of patellofemoral disorders.

The results of 50 arthroscopic lateral releases are reported. The average follow-up period was 36 months with a range of 18-52 months. Satisfactory results were achieved in 71% of 21 patients with patellar pain alone and in 76% of those (Betz RR, Lonergan R, Patterson R.

[Antero-lateral laxity or a combination of anterior and postero-lateral laxity? Therapeutic considerations].

The study involves a group of patients affected with inveterate lesion of the A.C.L.