196,222 research outputs found
Ricostruzione endoscopica del legamento crociato anteriore con innesto dal tendine quadricipitale e fissazione rigida: tecnica chirurgica
No full textWe present a new technique for the anterior cruciate ligament reconstruction, using a graft from the quadriceps tendon, in order to avoid the most common complications related to the use of the middle third of the patellar tendon or the hamstring grafts. The quadriceps tendon graft has biomechanical characteristics which are similar to those of the patellar tendon and of the hamstring grafts, thus allowing an ideal fixation on the bony end. There still are many doubts concerning the free end fixation, just as happens with the hamstring graft. Since 2000, a new method of femoral fixation has been available. This method uses two bioabsorbable pins (Rigid-Fix, Mitek, Ethicon, Westwood, Massachusetts, U.S.A.), for both the bone blocks and the soft-tissue ends. We describe the technique for the use of the quadricep's tendon graft with the soft end fixed to the femur by the Rigid-Fix system. The advantages of this technique are: reduced problems at the donor site, a cross sectional area 1.8 bigger than the patellar tendon graft, the transcondylar bioabsorbable fixation that gives the possibility to obtain a growth of the fibres by inserting the nails through the fibres of the graft, with a following enlargement of the tendon-bone contact area at reaming level. This technique, moreover, avoids the risk of secondary effects such as the windshield wiper effect and the bungee effect, caused by the unsatisfactory tibial fixation of the soft tissues. The use of the quadriceps tendon pro-ACL in the primary reconstruction, as a standard, is advisable in case of pre-operative pain in the anterior area, or when the patient does a working or sporting activity in a genuflected position
Acl reconstruction with quadriceps tendon graft: preliminary results of a new fixation tecnique
No full text
La tecnica di prelievo del tendine quadricipitale come innesto per la ricostruzione del LCA
No full textOsteochondritis Dissecans of the Knee and Articular Cartilage Fractures
No full textOsteochondritis, Dissecans, Knee, Cartilage Fracture
Patient-reported outcomes of intra-articular hyaluronic acid for osteoarthritis of the knee: a prospective and multicentric case series
No full textBackground: In the present study, patients with symptomatic knee osteoarthritis (OA) were treated with single intra-articular injection of a high molecular weight, non-cross-linked hyaluronic acid (HA), highly concentrated (2%) and associated with sorbitol (4%). The aims of this study were to (1) evaluate clinical outcome after 6 months, (2) evaluate clinical outcomes after 12 months and (3) evaluate clinical outcomes according to OA grade. Hypothesis of the study was that a single intra-articular injection of this HA associated with sorbitol leads to a significant clinical improvement within 6 months in patients with early or moderate knee OA. Materials and methods: A total of 77 patients were enrolled in this prospective multicentric study. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was recorded at baseline and at months 1, 3, 6 and 12 following the intra-articular injection. Moreover, a stratified analysis of all WOMAC items following the OA grade was performed for both groups of patients, one with low (grade I–II according to Kellgren–Lawrence classification) and another with moderate OA grade (grade III according to Kellgren–Lawrence) and the differences between groups were evaluated. Results: Seventy-three patients completed the 12 months follow-up. Pain, stiffness, functional limitation and total scores were significantly reduced at 1, 3 and 6 months (p < 0.05), but not at 12 months. Stratified analysis of all subscores according to OA grade showed that pain, functional limitation and total score decreased at 1, 3, 6 and 12 months (p < 0.05) in both groups. Stiffness was the only item that decreased significantly at 1, 3 and 6 months but not at 12 months in both groups. All subscore values were significantly lower in the group of patients with low OA grade compared to the one with moderate OA grade. No adverse events were reported. Conclusion: At 6 months after a single intra-articular injection of a high molecular weight, non-cross-linked HA associated with sorbitol, WOMAC scores decreased significantly. Clinical benefits were observed both in patients with low and in those with moderate OA grade, with better results in the first group
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