No abstract

No abstract

The aim of this study was to investigate effects of bone impaction technique on tunnel enlargement after ACL reconstruction at a minimum 2 years follow-up. Two groups of patients who had been operated upon with the same arthroscopic technique with the exception of tibial tunnel constitution were compared. Twenty-one patients of group A (drilling to 6 mm followed enlargement to 8-9 mm by using dilators) and 23 patients of group B (directly drilling to the size of the graft) were evaluated clinically and radiographically based on multislice computerised tomography (MSCT) retrospectively. At follow-up, there was no statistical difference between tunnel diameters between two groups at the femoral site, but significant difference at the tibial site (p= 0.00192 for coronal; p=0.0171 for sagittal diameter). Both groups were comparable according pre-and postoperative Lysholm and IKDC scores (p<0.5 Mann-Whitney U test). Compacted tunnel walls may resist enlargement, suggesting this technique resulted in better tunnel diameter values especially with intratunnel fixation.

Background: Pott's disease may cause late neurological involvement due to development of sharp kyphosis. Anterior decompression and fusion is the treatment of choice for this disorder. Objective: To determine the mid-term clinical results of patients with late onset Pott's paraplegia, who underwent anterior decompression and grafting after neurological deterioration. Setting: A university hospital in I . stanbul, Turkey. Methods: Eight patients who developed late onset paraplegia with a mean period of 24.6 years (range, 9 ± 46 years) after the active disease were treated with anterior decompression and grafting. The mean age at surgery was 36.1 years (range, 18 ± 63 years) and the mean duration of neurological deterioration before surgery was 7.4 weeks (range, 2 ± 13 weeks). The mean kyphosis angle of the patients was 105.638 (range, 808 ± 1358). No attempt to correct the curve was made in any operation. All but two patients' neurological status were evaluated according to the International Standards for Neurological and Functional Classi®cation of Spinal Cord Injury determined by ASIA-IMSOP on admission. Results: Neurological status of all patients showed progression either in Frankel scale or in motor scores in the early postoperative period. One patient needed to be reoperated on because of a deterioration of neurological status 26 months after surgery. The mean length of time since the operations is 75.9 months (range, 48 ± 173 months) and all the patients are carrying out their lives independently with a mean motor score of 97.5 and full pin-prick and light touch scores. Conclusions: Anterior decompression and grafting is an e ective procedure for the treatment of late onset paraplegia in Pott's disease. Spinal Cord (2000) 38, 669 ± 674

Extensive calcification of the patellar tendon following ACL reconstruction with central-third bone-patellar tendon-bone autograft is a rarely seen complication. A 45-year-old male patient underwent combined intraarticular reconstruction of ACL with 1/3 central patellar bone-tendon-bone graft and extraarticular reconstruction with modified MacIntosh technique. Two cm of calcification of the patellar tendon was observed incidentally when he underwent a high tibial osteotomy due to medial compartment degeneration, secondary to varus malalignment, 18 months after the ACL surgery. The calcification, being painless, was left untouched during the surgery. At the final examination, 136 months postoperatively, the patient still had no complaint relating to the patellar tendon.