Height can be used as a practical and accurate measurement to preoperatively predict quadruple hamstring graft diameter in male patients. Identification of possible hamstring tendon autograft insufficiency allows for preoperative determination of additional graft source possibilities, resulting in a more prompt surgical strategy.
Subcalcaneal heel pain is one of the most common foot ailments, yet the exact etiology is still controversial. Nerve entrapment has been suggested as one of the possible causes of this painful condition in recalcitrant cases. The purpose of this study is to determine the role of nerve entrapment in painful heels. Twenty patients with heel pain (25 heels) were compared with an age and body mass index-matched control population using electrodiagnostic methods. The results of the study revealed 22 heels (88%) with heel pain had lateral plantar nerve entrapment signs with or without medial plantar nerve findings on EMG. There were no abnormal values in the control group. Nerve entrapment syndrome has previously been considered only in cases with intractable heel pain, but this study suggests that it may play a role the early phases of painful heel syndrome.
Mild symptoms usually continue after excision of the medial patellar plica. We noticed that the palpable tender cord, located on the anteromedial aspect of the knee in patients with plica syndrome, did not disappear completely after excision of the synovial fold. Beneath all plicae, a retinacular band was visible, and only after excisions of this band did the cord become impalpable. We conducted a study to determine the role of these medial retinacular bands in the symptomatology of the disorder. Twenty-four knees of 22 patients diagnosed with medial patellar plica syndrome were divided into two groups. In the first group, arthroscopic excision of the synovial plica was performed. In the second group, retinacular bands beneath the plica were additionally excised. When Lysholm scores were compared, we found that the second group showed significantly greater improvement. We believe that the retinacular bands play a role in the symptomatology and the pathophysiology of plica syndrome and that excision improves the outcome.Résumé Habituellement des symptômes discrets persistent après excision du plica médiopatellaire. Nous avons constaté que le cordon palpable présent dans la partie antéromédiale du genou chez les malades avec un syndrome de plica n'a pas complètement disparu après excision du repli synovial. Sous tous les plicas une bande retinaculaire était visible et seulement après excision de cette bande le cordon est devenu impalpable. Nous avons conduit une étude pour déterminer le rôle de ces bandes rétinaculaire médiales dans la symptomatologie persistante. Vingt-quatre genoux de 22 malades présentant un syndrome du plica médio patellaire ont été divisés en 2 groupes. L'excision arthroscopique du plica synovial était faite dans le premier groupe et dans le deuxième groupe la bande rétinaculaire sous le plica a été excisée en plus. Quand les scores de Lysholm ont été comparés nous avons vu que le deuxième groupe avait une meilleure améliora-tion, statistiquement significative. Nous croyons que cette bande rétinaculaire joue un rôle dans la symptomatologie et la physiopathologie du syndrome du plica et que son excision améliore le résultat.
This experimental study compared bony healing and cartilage degeneration following strut grafting and trapdoor procedures for osteonecrosis of the femoral head in an ovine model. Osteonecrosis and a bony defect were created surgically in 16 hips of 8 Merino sheep, and the index grafting procedures were performed in a second session. Three months after surgery, the hips treated by strut grafting yielded better articular cartilage protection and bony healing compared to the osteonecrosis groups. The trapdoor group yielded better bony healing compared to the rest of the groups, but the grafts and the osteochondral flaps failed to unite with the host bone. These findings indicate elevating the osteochondral flap during the trapdoor procedure injures the cartilage and may cause degeneration.
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